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Development of an E-learning System for the Endoscopic Diagnosis of Early Gastric Cancer: An International Multicenter Randomized Controlled Trial

Yao K 1 , Uedo N 2 , Muto M 3 , Ishikawa H 4 , Cardona HJ 5 , Filho ECC 6 Show all authors , Pittayanon R 7 , Olano C 8 , Yao F 9 , Parra-Blanco A 10 , Ho SH 11 , Avendano AG 12 , Piscoya A 13 , Fedorov E 14 , Bialek AP 15 , Mitrakov A 16 , Caro L 17 , Gonen C 18 , Dolwani S 19 , Farca A 20 , Cuaresma LF 21 , Bonilla JJ 22 , Kasetsermwiriya W 23 , Ragunath K 24 , Kim SE 25 , Marini M 26 , Li H 27 , Cimmino DG 28 , Piskorz MM 29 , Iacopini F 30 , So JB 31 , Yamazaki K 32 , Kim GH 33 , Ang TL 34 , Milhomem-Cardoso DM 35 , Waldbaum CA 29 , Carvajal WAP 36 , Hayward CM 37 , Singh R 38 , Banerjee R 39 , Anagnostopoulos GK 40 , Takahashi Y 41

Affiliations 

  • 1 Fukuoka University Chikushi Hospital, Chikushino, Japan. Electronic address: yao@fukuoka-u.ac.jp
  • 2 Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
  • 3 Kyoto University, Kyoto, Japan
  • 4 Kyoto Prefectural University of Medicine, Kyoto, Japan
  • 5 Simon Bolivar Hospital, Bogota, Colombia
  • 6 Rio de Janeiro State University, Rio de Janeiro, Brazil
  • 7 King Chulalongkorn Memorial Hospital, The Thai Red Cross and Chulalongkorn University, Bangkok, Thailand
  • 8 Universidad de la República, Montevideo, Uruguay
  • 9 Peking Union Medical College Hospital, Beijing, China
  • 10 School of Medicine, Pontificia Universidad Catolica De Chile, Santiago, Chile
  • 11 University of Malaya, Kuala Lumpur, Malaysia
  • 12 Hospital Rafael Angel Calderon Guardia, CCSS, San Jose, Costa Rica
  • 13 Universidad Peruana de Ciencias Aplicadas, Lima, Peru
  • 14 Russia National Medical University, Moscow University Hospital, N31, Moscow, Russian Federation
  • 15 Pomeranian Medical University, Szczecin, Poland
  • 16 Nizhniy Novgorod Cancer Hospital, Nizhniy Novgorod, Russian Federation
  • 17 GEDyt Gastroenterologia diagnostica y tratamiento Inst afiliafa a la UBA Buenos Aires, Argentina
  • 18 Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
  • 19 Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, United Kingdom
  • 20 The American British Cowdray Medical Center. Mexico City, Mexico
  • 21 Hospital Nacional Adolfo Guevara Velasco, Cusco, Peru
  • 22 i-gastro/Hospital Central de la Fuerza Aerea del Peru, Lima, Peru
  • 23 Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
  • 24 NIHR Nottingham Digestive Disease Biomedical Research Unit, Queens Medical Centre, Nottingham University Hospital, Nottingham, United Kingdom
  • 25 Kosin University College of Medicine, Busan, Republic of Korea
  • 26 Gastroenterology and Operative Endoscopy Unit, Siena University Hospital, Siena, Italy
  • 27 Sichuan Provincial People's Hospital, Sichuan, Academy of Medical Sciences, Chengdu, China
  • 28 Hospital Aleman, Buenos Aires, Argentina
  • 29 Hospital de Clinicas Jose de San Martin, Buenos Aires, Argentina
  • 30 Ospedale S. Giuseppe, ASL Roma 6, Albano L, Rome, Italy
  • 31 National University of Singapore, Singapore, Singapore
  • 32 University of Sao Paulo, Sao Paulo, Brazil
  • 33 Pusan National University School of Medicine, Busan, Republic of Korea
  • 34 Changi General Hospital, Singapore, Singapore
  • 35 General Hospital of Goiania, Goiania, Brazil
  • 36 Hospital Mexico, San Jose, Costa Rica
  • 37 Derriford Hospital, Plymouth, United Kingdom
  • 38 Lyell McEwin Hospital & University of Adelaide, Adelaide, Australia
  • 39 Asian Institute of Gastroenterology, Hyderabad, India
  • 40 Mitera General Hospital, Athens, Greece
  • 41 FAST Inc., Tokyo, Japan
EBioMedicine, 2016 Jul;9:140-147.
PMID: 27333048 DOI: 10.1016/j.ebiom.2016.05.016

Abstract

BACKGROUND: In many countries, gastric cancer is not diagnosed until an advanced stage. An Internet-based e-learning system to improve the ability of endoscopists to diagnose gastric cancer at an early stage was developed and was evaluated for its effectiveness.

METHODS: The study was designed as a randomized controlled trial. After receiving a pre-test, participants were randomly allocated to either an e-learning or non-e-learning group. Only those in the e-learning group gained access to the e-learning system. Two months after the pre-test, both groups received a post-test. The primary endpoint was the difference between the two groups regarding the rate of improvement of their test results.

FINDINGS: 515 endoscopists from 35 countries were assessed for eligibility, and 332 were enrolled in the study, with 166 allocated to each group. Of these, 151 participants in the e-learning group and 144 in the non-e-learning group were included in the analysis. The mean improvement rate (standard deviation) in the e-learning and non-e-learning groups was 1·24 (0·26) and 1·00 (0·16), respectively (P<0·001).

INTERPRETATION: This global study clearly demonstrated the efficacy of an e-learning system to expand knowledge and provide invaluable experience regarding the endoscopic detection of early gastric cancer (R000012039).

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

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