CC BY 4.0 · Endoscopy 2024; 56(06): 412-420
DOI: 10.1055/a-2240-7823
Original article

Effect of an E-learning resource on endoscopists’ proximal serrated polyp detection rate: a randomized controlled trial

David E. F. W. M. van Toledo
1   Department of Gastroenterology and Hepatology, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, Netherlands
2   Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, Netherlands (Ringgold ID: RIN571165)
3   Cancer Centre Amsterdam, Amsterdam University Medical Centres, location Academic Medical Centre, Amsterdam, Netherlands
,
Joep E. G. IJspeert
1   Department of Gastroenterology and Hepatology, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, Netherlands
2   Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, Netherlands (Ringgold ID: RIN571165)
3   Cancer Centre Amsterdam, Amsterdam University Medical Centres, location Academic Medical Centre, Amsterdam, Netherlands
4   Department of Gastroenterology, Netherlands Cancer Institute-Antoni Van Leeuwenhoek, Amsterdam, Netherlands
,
Arne G. C. Bleijenberg
1   Department of Gastroenterology and Hepatology, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, Netherlands
2   Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, Netherlands (Ringgold ID: RIN571165)
3   Cancer Centre Amsterdam, Amsterdam University Medical Centres, location Academic Medical Centre, Amsterdam, Netherlands
,
Anne Depla
5   Department of Gastroenterology, DC Klinieken, Amsterdam, Netherlands
,
Nahid S. M. Montazeri
6   Biostatistics Unit, Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, location Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
,
1   Department of Gastroenterology and Hepatology, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, Netherlands
2   Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, Netherlands (Ringgold ID: RIN571165)
3   Cancer Centre Amsterdam, Amsterdam University Medical Centres, location Academic Medical Centre, Amsterdam, Netherlands
› Author Affiliations
Clinical Trial: Registration number (trial ID): NL8385, Trial registry: Netherlands National Trial Register (http://www.trialregister.nl), Type of Study: Randomized controlled multicenter study


Abstract

Background Recent studies demonstrated that a higher proximal serrated polyp detection rate (PSPDR) among endoscopists is associated with a lower risk of post-colonoscopy colorectal cancer (PCCRC) incidence and death for their patients. Our objective was to evaluate the effect of an e-learning resource on PSPDR.

Methods We performed a multicenter randomized controlled trial within the Dutch fecal immunochemical test-based colorectal cancer screening program. Endoscopists were randomized using block randomization per center to either receive a 60-minute e-learning resource on serrated polyp detection or not. PSPDR was calculated based on all colonoscopies performed during a 27-month pre-intervention and a 17-month post-intervention period. The primary end point was difference in PSPDR between intervention and control arms (intention to treat) using mixed effect logistic regression modeling, with time (pre-intervention/post-intervention) and interaction between time and arm (intervention/control) as fixed effects, and endoscopists as random effects.

Results 116 endoscopists (57 intervention, 59 controls) were included, and performed 27494 and 33888 colonoscopies, respectively. Median PSPDR pre-intervention was 13.6% (95%CI 13.0–14.1) in the intervention arm and 13.8% (95%CI 13.3–14.3) in controls. Post-intervention PSPDR was significantly higher over time in the intervention arm than in controls (17.1% vs. 15.4%, P=0.01).

Conclusion In an era of increased awareness and increasing PSPDRs, endoscopists who undertook a one-time e-learning course significantly accelerated the increase in PSPDR compared with endoscopists who did not undertake the e-learning. Widespread implementation might reduce PCCRC incidence.

Supplementary Material



Publication History

Received: 16 May 2023

Accepted after revision: 06 January 2024

Accepted Manuscript online:
08 January 2024

Article published online:
21 February 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
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