Efficacy of international web-based educational intervention in the detection of high-risk flat and depressed colorectal lesions higher (CATCH project) with a video: A randomized trial

Iwatate M 1 , Hirata D 1 , Francisco CPD 2 , Co JT 2 , Byeon JS 3 , Joshi N 4 Show all authors , Banerjee R 5 , Quach DT 6 , Aye TT 7 , Chiu HM 8 , Louis LH 9 , Ng SC 9 , Ang TL 10 , Khomvilai S 11 , Li XB 12 , Ho SH 13 , Sano W 1 , Hattori S 1 , Fujita M 1 , Murakami Y 14 , Shimatani M 15 , Kodama Y 16 , Sano Y 1

Affiliations 

  • 1 Gastrointestinal Center and Institute of Minimally invasive Endoscopic Care (iMEC), Sano Hospital, Hyogo, Japan
  • 2 Institute of Digestive and Liver Diseases, St. Luke's Medical Center, Global City, Taguig City, Metro Manila, Philippines
  • 3 Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
  • 4 Gastro Enterology Unit, Nepal Cancer Hospital & Research Centre, Lalitpur, Nepal
  • 5 Medical Gastroenterology, Asian Institute of Gastroenterology, New Delhi, India
  • 6 University of Medicine and Pharmacy at Hochiminh City, Hochiminh, Vietnam
  • 7 University of Medicine 2, Yangon, Myanmar
  • 8 Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
  • 9 Department of Medicine and Therapeutics, Faculty of Medicine, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China
  • 10 Department of Gastroenterology and Hepatology, Changi General Hospital, SingHealth, Singapore
  • 11 Surgical Endoscopy, Colorectal Division, Department of Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
  • 12 Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Renji Hospital, School of Medicine, Shanghai Institute of Digestive Disease, Shanghai Jiao Tong University, Shanghai, China
  • 13 Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  • 14 Department of Medical Statistics, Toho University, Tokyo, Japan
  • 15 The Third Department of Internal Medicine, Division of Gastroenterology and Hepatology, Kansai Medical University Medical Center, Osaka, Japan
  • 16 Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan
Dig Endosc, 2022 Feb 04.
PMID: 35122323 DOI: 10.1111/den.14244

Abstract

OBJECTIVE: Three high-risk flat and depressed lesions (FDLs), laterally spreading tumors non-granular type (LST-NG), depressed lesions, and large sessile serrated lesions (SSLs), are highly attributable to post-colonoscopy colorectal cancer (CRC). Efficient and organized educational programs on detecting high-risk FDLs are lacking. We aimed to explore whether a web-based educational intervention with training on FIND clues (fold deformation, intensive stool/mucus attachment, no vessel visibility, and demarcated reddish area) may improve the ability to detect high-risk FDLs.

METHODS: This was an international web-based randomized control trial that enrolled non-expert endoscopists in 13 Asian countries. The participants were randomized into either education or non-education group. All participants took the pre-test and post-test to read 60 endoscopic images (40 high-risk FDL, 5 polypoid, 15 no lesions) and answered whether there was a lesion. Only the education group received a self-education program (video and training questions and answers) between the tests. The primary outcome was a detection rate of high-risk FDLs.

RESULTS: In total, 284 participants were randomized. After excluding non-responders, the final data analyses were based on 139 participants in the education group and 130 in the non-education group. The detection rate of high-risk FDLs in the education group significantly improved by 14.7% (66.6% to 81.3%) compared with -0.8% (70.8% to 70.0%) in the non-education group. Similarly, the detection rate of LST-NG, depressed lesions, and large SSLs significantly increased only in the education group by 12.7%, 12.0%, and 21.6%, respectively.

CONCLUSION: Short self-education focusing on detecting high-risk FDLs was effective for Asian non-expert endoscopists. (UMIN000042348).

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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