CC BY-NC-ND 4.0 · Endosc Int Open 2019; 07(10): E1197-E1206
DOI: 10.1055/a-0962-9737
Original article
Owner and Copyright © Georg Thieme Verlag KG 2019

A simplified table using validated diagnostic criteria is effective to improve characterization of colorectal polyps: the CONECCT teaching program

Martin Fabritius
 1  Department of Endoscopy and Gastroenterology, Pavillon L, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
,
Jean-Michel Gonzalez
 2  Department of Endoscopy and Gastroenterology, Marseille university North Hospital, Marseille, France
 3  Research and development committee of the French Society of Digestive Endoscopy (SFED), Paris, France
,
Aymeric Becq
 3  Research and development committee of the French Society of Digestive Endoscopy (SFED), Paris, France
 4  Department of Digestive Diseases, Sorbonne University & APHP, Saint-Antoine Hospital, Paris, France
,
Xavier Dray
 3  Research and development committee of the French Society of Digestive Endoscopy (SFED), Paris, France
 4  Department of Digestive Diseases, Sorbonne University & APHP, Saint-Antoine Hospital, Paris, France
,
Emmanuel Coron
 3  Research and development committee of the French Society of Digestive Endoscopy (SFED), Paris, France
 5  Department of Endoscopy and Gastroenterology, Nantes university Hospital, Nantes, France
,
Lucie Brenet-Defour
 6  Department of Endoscopy and Gastroenterology, Reims university Hospital, Reims, France
,
Julien Branche
 3  Research and development committee of the French Society of Digestive Endoscopy (SFED), Paris, France
 7  Department of Endoscopy and Gastroenterology, Lille university Hospital, Lille, France
,
Romain Gerard
 7  Department of Endoscopy and Gastroenterology, Lille university Hospital, Lille, France
,
Côme Lepage
 6  Department of Endoscopy and Gastroenterology, Reims university Hospital, Reims, France
,
Laurent Poincloux
 3  Research and development committee of the French Society of Digestive Endoscopy (SFED), Paris, France
 8  Department of Endoscopy and Gastroenterology, Estaing university Hospital, Clermont-Ferrand, France
,
Isabelle Lienhart
 1  Department of Endoscopy and Gastroenterology, Pavillon L, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
 9  Department of Endoscopy and Gastroenterology, Annecy Hospital, Metz-Tessy, France
,
Paul Bonniaud
 1  Department of Endoscopy and Gastroenterology, Pavillon L, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
,
Mohamed Tayeb Bounnah
10  Department of Gastroenterology, Constantine university hospital, Alger, Algeria
,
Jérôme Rivory
 1  Department of Endoscopy and Gastroenterology, Pavillon L, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
 3  Research and development committee of the French Society of Digestive Endoscopy (SFED), Paris, France
,
Vincent Lépilliez
 3  Research and development committee of the French Society of Digestive Endoscopy (SFED), Paris, France
11  Department of Endoscopy and Gastroenterology, Mermoz hospital, Lyon.
,
Fabien Subtil
12  Univ. Lyon, Université Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Evolutive UMR 5558, Villeurbanne, France
,
Jean-Christophe Saurin
 1  Department of Endoscopy and Gastroenterology, Pavillon L, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
 3  Research and development committee of the French Society of Digestive Endoscopy (SFED), Paris, France
,
Thierry Ponchon
 1  Department of Endoscopy and Gastroenterology, Pavillon L, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
 3  Research and development committee of the French Society of Digestive Endoscopy (SFED), Paris, France
14  Inserm U1032 LabTau, Lyon, France
,
Jérémie Jacques
 3  Research and development committee of the French Society of Digestive Endoscopy (SFED), Paris, France
13  Department of Endoscopy and Gastroenterology, Dupuytren university Hospital, Limoges, France
,
Mathieu Pioche
 1  Department of Endoscopy and Gastroenterology, Pavillon L, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
 3  Research and development committee of the French Society of Digestive Endoscopy (SFED), Paris, France
14  Inserm U1032 LabTau, Lyon, France
› Author Affiliations
Further Information

Publication History

submitted 18 January 2019

accepted after revision 19 June 2019

Publication Date:
01 October 2019 (online)

  

Abstract

Introduction and study aims Accurate real-time endoscopic characterization of colorectal polyps is key to choosing the most appropriate treatment. Mastering the currently available classifications is challenging. We used validated criteria for these classifications to create a single table, named CONECCT, and evaluated the impact of a teaching program based on this tool.

Methods A prospective multicenter study involving GI fellows and attending physicians was conducted. During the first session, each trainee completed a pretest consisting in histological prediction and choice of treatment of 20 colorectal polyps still frames. This was followed by a 30-minute course on the CONECCT table, before taking a post-test using the same still frames reshuffled. During a second session at 3 – 6 months, a last test (T3 M) was performed, including these same still frames and 20 new ones.

Results A total 419 participants followed the teaching program between April 2017 and April 2018. The mean proportion of correctly predicted/treated lesions improved significantly from pretest to post-test and to T3 M, from 51.0 % to 74.0 % and to 66.6 % respectively (P < 0.001). Between pretest and post-test, 343 (86.6 %) trainees improved, and 153 (75.4 %) at T3 M. Significant improvement occurred for each subtype of polyp for fellows and attending physicians. Between the two sessions, trainees continued to progress in the histology prediction and treatment choice of polyps CONECCT IIA. Over-treatment decreased significantly from 30.1 % to 15.5 % at post-test and to 18.5 % at T3 M (P < 0.001).

Conclusion The CONECCT teaching program is effective to improve the histology prediction and the treatment choice by gastroenterologists, for each subtype of colorectal polyp.