Development and validation of a video-based cold snare polypectomy assessment tool (with videos)

Swati G. Patel, Anna Duloy, Tonya Kaltenbach, Matt Hall, Charles Kahi, Heiko Pohl, Amit Rastogi, Hazem Hammad, Roy Soetikno, Amandeep Shergill, Violette Simon, Tiffany Nguyen, Eze Ezekwe, Tara Ahi, Rajesh N. Keswani, Sachin Wani

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background and Aims: Polyps <1 cm are the most commonly found polyps during colonoscopy. Cold snare removal is preferred given the significantly higher rate of incomplete resection associated with piecemeal biopsy forceps resection. There are currently no standardized tools to assess competence in cold snare polypectomy. This study aimed to develop and validate a cold snare polypectomy assessment tool (CSPAT). Methods: Experts in cold snare polypectomy used a Delphi method to develop the CSPAT. Metrics with a greater than 85% agreement as being “important” or “very important” were included in the CSPAT. The tool included evaluation of polyp inspection, positioning, appropriate ensnarement of tissue to ensure a rim of normal tissue, tissue retrieval, and postpolypectomy site inspection. Experts in cold snare polypectomy used the CSPAT to evaluate preselected videos that were previously evaluated using the Direct Observation of Polypectomy Skills (DOPyS) tool. Interobserver agreement was evaluated. CSPAT scores were compared with DOPyS scores to assess content validity. Results: Sixteen experts developed the 12-item CSPAT, and 13 experts reviewed 55 videos. There was a moderate degree of agreement in 10 metrics (κ =.52-.59) and a substantial degree of agreement (κ =.61-.63) in the other 2. There was a strong correlation between the mean of individual metrics 1 to 12 compared with the global competence assessment (ρ =.88, P <.001). There was a moderate correlation between the average overall DOPyS score and the overall CSPAT competence score (ρ =.56, P <.001). Conclusions: We have developed and validated a customized CSPAT that can be easily applied to video-based assessments to assess competence in training and among practicing endoscopists.

Original languageEnglish (US)
JournalGastrointestinal Endoscopy
DOIs
StatePublished - Jan 1 2019
Externally publishedYes

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Mental Competency
Polyps
Observation
Colonoscopy
Surgical Instruments
Biopsy

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

Development and validation of a video-based cold snare polypectomy assessment tool (with videos). / Patel, Swati G.; Duloy, Anna; Kaltenbach, Tonya; Hall, Matt; Kahi, Charles; Pohl, Heiko; Rastogi, Amit; Hammad, Hazem; Soetikno, Roy; Shergill, Amandeep; Simon, Violette; Nguyen, Tiffany; Ezekwe, Eze; Ahi, Tara; Keswani, Rajesh N.; Wani, Sachin.

In: Gastrointestinal Endoscopy, 01.01.2019.

Research output: Contribution to journalArticle

Patel, SG, Duloy, A, Kaltenbach, T, Hall, M, Kahi, C, Pohl, H, Rastogi, A, Hammad, H, Soetikno, R, Shergill, A, Simon, V, Nguyen, T, Ezekwe, E, Ahi, T, Keswani, RN & Wani, S 2019, 'Development and validation of a video-based cold snare polypectomy assessment tool (with videos)', Gastrointestinal Endoscopy. https://doi.org/10.1016/j.gie.2019.02.018
Patel, Swati G. ; Duloy, Anna ; Kaltenbach, Tonya ; Hall, Matt ; Kahi, Charles ; Pohl, Heiko ; Rastogi, Amit ; Hammad, Hazem ; Soetikno, Roy ; Shergill, Amandeep ; Simon, Violette ; Nguyen, Tiffany ; Ezekwe, Eze ; Ahi, Tara ; Keswani, Rajesh N. ; Wani, Sachin. / Development and validation of a video-based cold snare polypectomy assessment tool (with videos). In: Gastrointestinal Endoscopy. 2019.
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abstract = "Background and Aims: Polyps <1 cm are the most commonly found polyps during colonoscopy. Cold snare removal is preferred given the significantly higher rate of incomplete resection associated with piecemeal biopsy forceps resection. There are currently no standardized tools to assess competence in cold snare polypectomy. This study aimed to develop and validate a cold snare polypectomy assessment tool (CSPAT). Methods: Experts in cold snare polypectomy used a Delphi method to develop the CSPAT. Metrics with a greater than 85{\%} agreement as being “important” or “very important” were included in the CSPAT. The tool included evaluation of polyp inspection, positioning, appropriate ensnarement of tissue to ensure a rim of normal tissue, tissue retrieval, and postpolypectomy site inspection. Experts in cold snare polypectomy used the CSPAT to evaluate preselected videos that were previously evaluated using the Direct Observation of Polypectomy Skills (DOPyS) tool. Interobserver agreement was evaluated. CSPAT scores were compared with DOPyS scores to assess content validity. Results: Sixteen experts developed the 12-item CSPAT, and 13 experts reviewed 55 videos. There was a moderate degree of agreement in 10 metrics (κ =.52-.59) and a substantial degree of agreement (κ =.61-.63) in the other 2. There was a strong correlation between the mean of individual metrics 1 to 12 compared with the global competence assessment (ρ =.88, P <.001). There was a moderate correlation between the average overall DOPyS score and the overall CSPAT competence score (ρ =.56, P <.001). Conclusions: We have developed and validated a customized CSPAT that can be easily applied to video-based assessments to assess competence in training and among practicing endoscopists.",
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AU - Patel, Swati G.

AU - Duloy, Anna

AU - Kaltenbach, Tonya

AU - Hall, Matt

AU - Kahi, Charles

AU - Pohl, Heiko

AU - Rastogi, Amit

AU - Hammad, Hazem

AU - Soetikno, Roy

AU - Shergill, Amandeep

AU - Simon, Violette

AU - Nguyen, Tiffany

AU - Ezekwe, Eze

AU - Ahi, Tara

AU - Keswani, Rajesh N.

AU - Wani, Sachin

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background and Aims: Polyps <1 cm are the most commonly found polyps during colonoscopy. Cold snare removal is preferred given the significantly higher rate of incomplete resection associated with piecemeal biopsy forceps resection. There are currently no standardized tools to assess competence in cold snare polypectomy. This study aimed to develop and validate a cold snare polypectomy assessment tool (CSPAT). Methods: Experts in cold snare polypectomy used a Delphi method to develop the CSPAT. Metrics with a greater than 85% agreement as being “important” or “very important” were included in the CSPAT. The tool included evaluation of polyp inspection, positioning, appropriate ensnarement of tissue to ensure a rim of normal tissue, tissue retrieval, and postpolypectomy site inspection. Experts in cold snare polypectomy used the CSPAT to evaluate preselected videos that were previously evaluated using the Direct Observation of Polypectomy Skills (DOPyS) tool. Interobserver agreement was evaluated. CSPAT scores were compared with DOPyS scores to assess content validity. Results: Sixteen experts developed the 12-item CSPAT, and 13 experts reviewed 55 videos. There was a moderate degree of agreement in 10 metrics (κ =.52-.59) and a substantial degree of agreement (κ =.61-.63) in the other 2. There was a strong correlation between the mean of individual metrics 1 to 12 compared with the global competence assessment (ρ =.88, P <.001). There was a moderate correlation between the average overall DOPyS score and the overall CSPAT competence score (ρ =.56, P <.001). Conclusions: We have developed and validated a customized CSPAT that can be easily applied to video-based assessments to assess competence in training and among practicing endoscopists.

AB - Background and Aims: Polyps <1 cm are the most commonly found polyps during colonoscopy. Cold snare removal is preferred given the significantly higher rate of incomplete resection associated with piecemeal biopsy forceps resection. There are currently no standardized tools to assess competence in cold snare polypectomy. This study aimed to develop and validate a cold snare polypectomy assessment tool (CSPAT). Methods: Experts in cold snare polypectomy used a Delphi method to develop the CSPAT. Metrics with a greater than 85% agreement as being “important” or “very important” were included in the CSPAT. The tool included evaluation of polyp inspection, positioning, appropriate ensnarement of tissue to ensure a rim of normal tissue, tissue retrieval, and postpolypectomy site inspection. Experts in cold snare polypectomy used the CSPAT to evaluate preselected videos that were previously evaluated using the Direct Observation of Polypectomy Skills (DOPyS) tool. Interobserver agreement was evaluated. CSPAT scores were compared with DOPyS scores to assess content validity. Results: Sixteen experts developed the 12-item CSPAT, and 13 experts reviewed 55 videos. There was a moderate degree of agreement in 10 metrics (κ =.52-.59) and a substantial degree of agreement (κ =.61-.63) in the other 2. There was a strong correlation between the mean of individual metrics 1 to 12 compared with the global competence assessment (ρ =.88, P <.001). There was a moderate correlation between the average overall DOPyS score and the overall CSPAT competence score (ρ =.56, P <.001). Conclusions: We have developed and validated a customized CSPAT that can be easily applied to video-based assessments to assess competence in training and among practicing endoscopists.

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