Gimpaya, Nikko

Abstract Background Real-time endoscopic optical diagnosis involves detailed visualization of the digestive mucosal and microvascular pattern, allowing for prediction of histology. This is advantageous as it can guide endoscopic resection decisions, surgical referrals and provide cost savings to histopathology. There is, however, no standardized or widely implemented curriculum for endoscopists or trainees to learn optical diagnosis skills. Aims To evaluate the impact of a course for the optical diagnosis of esophageal squamous cell carcinoma (ESCC), early gastric cancer (EGC), Barrett’s esophagus (BE), and colorectal polyps Methods 19 gastroenterology trainees were invited to the 2-day course in Kingston, Canada. Number of procedures previously performed was recorded. The impact of the course on lesion diagnosis accuracy was evaluated using a pre-test, immediate post-test, and delayed post-test administered 6 weeks after the course. A repeated measures ANOVA was performed to compare the mean score (%) between the three tests. Results 13 trainees completed all the tests (Table 1). Mean score % values for the overall tests and test scores for esophageal, gastric, and colon lesions were summarized on Table 1. The repeated measures ANOVA determined that the mean score % had a statistically significant difference between the three tests (F (2,24)=5.63, P=0.01). Pairwise comparisons revealed that there was a statistically significant increase in mean scores between pre- and post-tests (13.86 (95% confidence interval (CI) of 4.36 to 23.33), p<0.01) with no significant difference between post and delayed post-tests (8.46 (95% CI of -0.12 to 17.04), p>0.05) (Figure 1). The mean correct % from the delayed post-test was higher than the pre-test but there was no statistical significance (5.39 (95% CI of -3.72 to 14.49), p>0.05). Conclusions This novel optical diagnosis course improved trainee accuracy in diagnosing ESCC, EGC, BE and colorectal polyps. Learning retention was evident, with no significant score difference between immediate and delayed post-tests. This study was limited by the low sample size and low number of test items. Further investigation is required to validate the course for international trainees and explore its clinical transferability. Demography and Mean Score % Figure 1. Mean score %. (*) denotes p<0.05. Funding Agencies None

Abstract Background and study aims Use of fluoroscopy in gastrointestinal endoscopy is an essential aid in advanced endoscopic interventions. However, it also raises concerns about radiation exposure. This study aimed to develop consensus-based statements for safe and effective use of fluoroscopy in gastrointestinal endoscopy, prioritizing the safety and well-being of healthcare workers and patients. Methods A modified Delphi approach was employed to achieve consensus over three rounds of surveys. Proposed statements were generated in Round 1. In the second round, panelists rated potential statements on a 5-point scale, with consensus defined as ≥80% agreement. Statements were subsequently prioritized in Round 3, using a 1 (lowest priority) to 10 (highest priority) scale. Results Forty-six experts participated, consisting of 34 therapeutic endoscopists and 12 endoscopy nurses from six continents, with an overall 45.6% female representation (n = 21). Forty-three item statements were generated in the first round. Of these, 31 statements achieved consensus after the second round. These statements were categorized into General Considerations (n = 6), Education (n = 10), Pregnancy (n = 4), Family Planning (n = 2), Patient Safety (n = 4), and Staff Safety (n = 5). In the third round, accepted statements received mean priority scores ranging from 7.28 to 9.36, with 87.2% of statements rated as very high priority (mean score ≥ 9). Conclusions This study presents consensus-based statements for safe and effective use of fluoroscopy in gastrointestinal endoscopy, addressing the well-being of healthcare workers and patients. These consensus-based statements aim to mitigate risks associated with radiation exposure while maintaining benefits of fluoroscopy, ultimately promoting a culture of safety in healthcare settings.