Definition of competence standards for optical diagnosis of diminutive colorectal polyps: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement
Por:
Houwen, B, Hassan, C, Coupe, V, Greuter, M, Hazewinkel, Y, Vleugels, J, Antonelli, G, Bustamante-Balen, M, Coron, E, Cortas, G, Dinis-Ribeiro, M, Dobru, D, East, J, Lacucci, M, Jover, R, Kuvaev, R, Neumann, H, Pellise, M, Puig, I, Rutter, M, Saunders, B, Tate, D, Mori, Y, Longcroft-Wheaton, G, Bisschops, R and Dekker, E
Publicada:
1 ene 2022
Ahead of Print:
1 dic 2021
Resumen:
Background The European Society of Gastrointestinal Endoscopy (ESGE) has developed a core curriculum for high quality optical diagnosis training for practice across Europe. The development of easy-to-measure competence standards for optical diagnosis can optimize clinical decision-making in endoscopy. This manuscript represents an official Position Statement of the ESGE aiming to define simple, safe, and easy-to-measure competence standards for endoscopists and artificial intelligence systems performing optical diagnosis of diminutive colorectal polyps (1 - 5 mm). Methods A panel of European experts in optical diagnosis participated in a modified Delphi process to reach consensus on Simple Optical Diagnosis Accuracy (SODA) competence standards for implementation of the optical diagnosis strategy for diminutive colorectal polyps. In order to assess the clinical benefits and harms of implementing optical diagnosis with different competence standards, a systematic literature search was performed. This was complemented with the results from a recently performed simulation study that provides guidance for setting alternative competence standards for optical diagnosis. Proposed competence standards were based on literature search and simulation study results. Competence standards were accepted if at least 80 % agreement was reached after a maximum of three voting rounds. Recommendation 1 In order to implement the leave-in-situ strategy for diminutive colorectal lesions (1-5 mm), it is clinically acceptable if, during real-time colonoscopy, at least 90 % sensitivity and 80 % specificity is achieved for high confidence endoscopic characterization of colorectal neoplasia of 1-5 mm in the rectosigmoid. Histopathology is used as the gold standard. Level of agreement 95 %. Recommendation 2 In order to implement the resect-and-discard strategy for diminutive colorectal lesions (1-5 mm), it is clinically acceptable if, during real-time colonoscopy, at least 80 % sensitivity and 80 % specificity is achieved for high confidence endoscopic characterization of colorectal neoplasia of 1-5 mm. Histopathology is used as the gold standard. Level of agreement 100 %. Conclusion The developed SODA competence standards define diagnostic performance thresholds in relation to clinical consequences, for training and for use when auditing the optical diagnosis of diminutive colorectal polyps.
Filiaciones:
Houwen, B:
Univ Amsterdam, Dept Gastroenterol & Hepatol, Amsterdam Univ Med Ctr, Locat AMC, Amsterdam, Netherlands
Hassan, C:
Humanitas Univ, Dept Biomed Sci, Milan, Italy
IRCCS Humanitas Clin & Res Ctr, Endoscopy Unit, Milan, Italy
Coupe, V:
Amsterdam Univ Med Ctr, Locat VUmc, Dept Epidemiol & Data Sci, Amsterdam, Netherlands
Greuter, M:
Amsterdam Univ Med Ctr, Locat VUmc, Dept Epidemiol & Data Sci, Amsterdam, Netherlands
Hazewinkel, Y:
Radboud Univ Nijmegen, Radboud Univ Med Ctr, Dept Gastroenterol & Hepatol, Nijmegen, Netherlands
Vleugels, J:
Univ Amsterdam, Dept Gastroenterol & Hepatol, Amsterdam Univ Med Ctr, Locat AMC, Amsterdam, Netherlands
Antonelli, G:
Osped Castelli Hosp, Gastroenterol & Digest Endoscopy Unit, Rome, Italy
Bustamante-Balen, M:
La Fe Polytech Univ Hosp, Digest Dis Dept, Gastrointestinal Endoscopy Unit, Valencia, Spain
La Fe Hlth Res Inst, Gastrointestinal Endoscopy Res Grp, Valencia, Spain
Coron, E:
Inst Malad Appareil Digestif, Nantes, France
Cortas, G:
Univ Balamand, Div Gastroenterol, Fac Med, St George Hosp Univ Med Ctr, Beirut, Lebanon
Dinis-Ribeiro, M:
Porto Comprehens Canc Ctr Porto CCC, Porto, Portugal
RISE CI IPOP Hlth Res Network, Porto, Portugal
Dobru, D:
George Emil Palade Univ Med Pharm Sci & Technol T, Gastroenterol Dept, Targu Mures, Romania
East, J:
Univ Oxford, John Radcliffe Hosp, Translat Gastroenterol Unit, Nuffield Dept Med,Expt Med Div, Oxford, England
Mayo Clin Healthcare, Div Gastroenterol & Hepatol, London, England
Lacucci, M:
Univ Birmingham, Inst Translat Med, Birmingham, W Midlands, England
Univ Birmingham, Inst Immunol & Lmmunotherapy, Birmingham, W Midlands, England
Univ Birmingham, NIHR Biomed Res Ctr, Birmingham, W Midlands, England
Univ Hosp Birmingham NHS Fdn Trust, Birmingham, W Midlands, England
:
Univ Miguel Hernandez, Serv Med Digest, Inst Invest Sanitaria ISABIAL, Hosp Gen Univ Alicante, Alicante, Spain
Kuvaev, R:
Yaroslavl Reg Canc Hosp, Endoscopy Dept, Yaroslavl, Russia
NA Pirogov Russian Natl Res Med Univ, Fac Addit Profess Educ, Dept Gastroenterol, Moscow, Russia
Neumann, H:
Univ Med Ctr Mainz, Dept Med 1, Mainz, Germany
GastroZentrum, Lippe, Germany
Pellise, M:
Hosp Clin Barcelona, Dept Gastroenterol, Barcelona, Spain
Univ Barcelona, Inst Invest Biomed August Pi & Sunyer IDIBAP, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Barcelona, Spain
Puig, I:
Althaia Xarxa Assistencial Univ Manresa, Digest Dis Dept, Manresa, Spain
Univ Vic Univ Cent Catalunya UVic UCC, Fac Ciencies Salut, Dept Med, Manresa, Spain
Rutter, M:
Newcastle Univ, Fac Med Sci, Newcastle Upon Tyne, Tyne & Wear, England
Univ Hosp North Tees, Stockton On Tees, England
Saunders, B:
St Marks Hosp & Acad Inst, Dept Gastroenterol, Harrow, Middx, England
Tate, D:
Univ Ghent, Dept Gastroenterol & Hepatol, Ghent, Belgium
Univ Hosp Ghent, Ghent, Belgium
Mori, Y:
Univ Oslo, Inst Hlth & Soc, Clin Effectiveness Res Grp, Oslo, Norway
Oslo Univ Hosp, Dept Transplantat Med, Sect Gastroenterol, Oslo, Norway
Showa Univ, Northern Yokohama Hosp, Digest Dis Ctr, Yokohama, Kanagawa, Japan
Longcroft-Wheaton, G:
Portsmouth Hosp Univ NHS Trust, Portsmouth, Hants, England
Bisschops, R:
Katholieke Univ Leuven, Dept Gastroenterol & Hepatol, KUL, TARGID,Univ Hosp Leuven, Leuven, Belgium
Dekker, E:
Univ Amsterdam, Dept Gastroenterol & Hepatol, Amsterdam Univ Med Ctr, Locat AMC, Amsterdam, Netherlands
Sapienza Univ Rome, Dept Anat Histol Forens Med & Orthoped Sci, Rome, Italy.
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