Differentiating adenomas from hyperplastic colorectal polyps

Narrow-band imaging can be learned in 20 minutes

Meghana Raghavendra, David G. Hewett, Douglas Rex

Research output: Contribution to journalArticle

108 Citations (Scopus)

Abstract

Background: Colonoscopy with narrow-band imaging can allow real-time determination of polyp histology. Objective: To determine whether physicians with varying levels of experience can learn and apply endoscopic criteria to distinguish between adenomas and hyperplastic polyps. Design: Prospective observational study. Setting: University teaching hospital. Participants: This study involved 37 physicians (medical residents, N = 12; gastroenterology fellows, N = 12; and gastroenterology faculty, N = 13). Intervention: Small-group, 20-minute, didactic teaching sessions in which the endoscopic criteria for determining polyp histology by using narrow-band imaging were described and demonstrated. Main Outcome Measurements: Learning outcomes were evaluated by using written pretests and posttests in which participants scored pathologically verified, high-definition polyp photographs as adenomas or hyperplastic polyps. Results: The mean overall scores increased significantly from 47.6% correct on the pretest to 90.8% correct on the posttest (P = .0001). The overall mean percentage of responses answered don't know was significantly lower on the posttest (0.6%) compared with the pretest (20.5%, P < .0001). After training, the level of agreement was substantial (κ = 0.69 for all participants, κ = 0.79 for fellows). Limitations: Our study did not assess for sustained improvement with time or in vivo accuracy of histological prediction during live colonoscopy. Further validation in a sample of community physicians is required. Conclusion: A short, didactic teaching session can achieve high accuracy and good interobserver agreement in the use of narrow-band imaging for determining the histology of colorectal polyps.

Original languageEnglish
Pages (from-to)572-576
Number of pages5
JournalGastrointestinal Endoscopy
Volume72
Issue number3
DOIs
StatePublished - Sep 2010

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Narrow Band Imaging
Polyps
Adenoma
Histology
Gastroenterology
Colonoscopy
Physicians
Teaching
Teaching Hospitals
Observational Studies
Learning
Prospective Studies

ASJC Scopus subject areas

  • Gastroenterology
  • Radiology Nuclear Medicine and imaging

Cite this

Differentiating adenomas from hyperplastic colorectal polyps : Narrow-band imaging can be learned in 20 minutes. / Raghavendra, Meghana; Hewett, David G.; Rex, Douglas.

In: Gastrointestinal Endoscopy, Vol. 72, No. 3, 09.2010, p. 572-576.

Research output: Contribution to journalArticle

Raghavendra, Meghana ; Hewett, David G. ; Rex, Douglas. / Differentiating adenomas from hyperplastic colorectal polyps : Narrow-band imaging can be learned in 20 minutes. In: Gastrointestinal Endoscopy. 2010 ; Vol. 72, No. 3. pp. 572-576.
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