Detalhes bibliográficos
| Autor(a) principal: |
Castela,Joana |
| Data de Publicação: |
2019 |
| Outros Autores: |
Ferro,Susana Mão de,
Rosa,Isadora,
Lage,Pedro,
Ferreira,Sara,
Silva,João Pereira,
Pinto,João Cortez,
Rodrigues,Rita Vale,
Moleiro,Joana,
Claro,Isabel,
Esteves,Susana,
Pereira,António Dias |
| Tipo de documento: |
Artigo
|
| Idioma: |
eng |
| Título da fonte: |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
| Texto Completo: |
http://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452019000500003
|
Resumo: |
Background: Narrow-band imaging (NBI) allows in vivo classification of colorectal polyps. Objectives: We evaluated the optical diagnosis by nonexpert community-based endoscopists in routine clinical practice, the impact of training, and whether the endoscopists could achieve the threshold for the do not resect policy. Methods: This was an observational study performed in two periods (P1 and P2). Endoscopists had no prior experience in NBI in P1 and applied the technique on a daily basis for 1 year before participation in P2. Lesions were classified by applying the NBI International Colorectal Endoscopic (NICE) and Workgroup serrAted polyps and Polyposis (WASP) classifications, simultaneously. Results: A total of 290 polyps were analyzed. The overall accuracyof optical diagnosis was 0.75 (95% CI 0.68-0.81) in P1, with an increase to 0.82 (95% CI 0.73-0.89) in P2 (p = 0.260). The accuracy of the NICE/WASP classifications to differentiate adenomatous from nonadenomatous histology was 0.78 (95% CI 0.72-0.84) in P1 and 0.86 (95% CI 0.77-0.92) in P2 (p = 0.164); assignments made with a high confidence level achieved statistical significance (13% improvement, 95% CI 3-22%; p = 0.022). The negative predictive value for adenomatous histology of diminutive rectosigmoid polyps was 81% (95% CI 64-93%) and 80% (95% CI 59-93%) in P1 and P2, respectively. Conclusions: Nonexpert endoscopists achieved moderate accuracy for real-time optical diagnosis of colorectal lesions with the NICE/WASP classifications. The overall performance of the endoscopists improved after sustained use of optical diagnosis, but did not achieve the standards for the implementation of the do not resect strategy. |