Clinical Endoscopy

Original Article

External Validation of the Endoscopic Features of Sessile Serrated Adenomas in Expert and Trainee Colonoscopists: Hyo-Joon Yang, Jeong In Lee, Soo-Kyung Park, Yoon Suk Jung, Jin Hee Sohn, Kyu Yong Choi, Dong Il Park; Clin Endosc 2017;50(3):279-286. Published online September 13, 2016; DOI: https://doi.org/10.5946/ce.2016.107

Abstract PDF Supplementary Material PubReader ePub

Background
/Aims: It is unclear whether the endoscopic features of sessile serrated adenomas (SSAs) would be useful to trainee colonoscopists to predict SSA. Therefore, the present study aimed to identify features that expert and trainee colonoscopists can use to independently and reliably predict SSA by using high-resolution white-light endoscopy.
Methods
Endoscopic images of 81 polyps (39 SSAs, 22 hyperplastic polyps, and 20 tubular adenomas) from 43 patients were retrospectively evaluated by 10 colonoscopists (four experts and six trainees). Eight endoscopic features of SSAs were assessed for each polyp.
Results
According to multivariable analysis, a mucous cap (odds ratio [OR], 10.44; 95% confidence interval [CI], 5.72 to 19.07), indistinctive borders (OR, 4.21; 95% CI, 2.74 to 7.16), dark spots (OR, 3.64; 95% CI, 1.89 to 7.00), and cloud-like surface (OR, 2.43; 95% CI, 1.27 to 4.668) were independent predictors of SSAs. Among these, a mucous cap, indistinctive borders, and cloud-like surface showed moderate interobserver agreement (mean κ >0.40) among experts and trainees. When ≥1 of the three predictors was observed, the sensitivity and specificity for diagnosing SSAs were 79.0% and 81.4%, respectively.
Conclusions
Colonoscopy trainees and experts can use several specific endoscopic features to independently and reliably predict SSAs.

Citations

Citations to this article as recorded by

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Thi Khuc, Amol Agarwal, Feng Li, Sergey Kantsevoy, Bryan Curtin, Matilda Hagan, Mary Harris, Anurag Maheshwari, Amit Raina, Elinor Zhou, Paul Thuluvath
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Interpretation of Capsule Endoscopy: Expert versus Novice: Sung Woo Jung, M.D., Hoon Jai Chun, M.D., Bora Keum, M.D., Sung Chul Park, M.D.,Rok Son Choung, M.D., Yoon Tae Jeen, M.D., Hong Sik Lee, M.D., Yong Sik Kim, M.D.,Soon Ho Um, M.D., Sang Woo Lee, M.D., Jai Hyun Choi, M.D., Chang Duck Kim, M.D.,Ho Sang Ryu,; Korean J Gastrointest Endosc 2004;29(2):58-62. Published online August 30, 2004

Abstract PDF: Background
/Aims: Capsule endoscopy (CE) is a new method enabling noninvasive diagnosis of small bowel diseases. There have been few studies examining the possibility of interobserver variation according to proficiency. We evaluated the interobserver variability between expert and novice for reviewing CE images. Methods: Among patients who were taken CE from June 2003 to July 2003, twenty patients were randomly selected. Captured images were assessed by an expert and a novice separately. The expert has experience of more than 150 CE interpretation and the novice only had experience in performing EGD and colonoscopy. The novice had trained on interpretation of the CE with 5 cases before this study. Interobserver agreement was evaluated using kappa coefficient. Results: CE findings were divided into normal/ abnormal groups. Abnormal groups were classified into small focal, large focal, multiple diffuse, structural deformity groups. Compared with the expert, the novice missed 2 cases (Meckel's diverticulum and angiodysplasia). There was no disagreement in other cases. Conclusion: There is 90% (18/20) interobserver agreement between the expert and the novice for the interpetation of findings CE (k=0.737). Normal findings and diffuse large lesions tended to have higher concordance, whereas small focal lesion and structural deformities were more likely to be a source of disagreement. (Korean J Gastrointest Endosc 2004;29:58⁣62)

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