Endoscopy 2017; 49(10): 957-967
DOI: 10.1055/s-0043-111888
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Evaluation of an e-learning system for diagnosis of gastric lesions using magnifying narrow-band imaging: a multicenter randomized controlled study

Hiroyoshi Nakanishi
Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
,
Hisashi Doyama
Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
,
Hideki Ishikawa
Department of Molecular-Targeting Cancer Prevention, Kyoto Prefectural University of Medicine, Kyoto, Japan
,
Noriya Uedo
Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
,
Takuji Gotoda
Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
,
Mototsugu Kato
Division of Endoscopy, Hokkaido University Hospital, Sapporo, Japan
,
Shigeaki Nagao
Department of Internal Medicine, National Defense Medical College, Saitama, Japan
,
Yasuaki Nagami
Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
,
Hiroyuki Aoyagi
Department of Gastroenterology, Fukui Prefectural Hospital, Fukui, Japan
,
Atsushi Imagawa
Department of Gastroenterology, Mitoyo General Hospital, Kan-onji, Japan
,
Junichi Kodaira
Department of Gastroenterology, Keiyukai Sapporo Hospital, Sapporo, Japan
,
Shinya Mitsui
Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
,
Nozomu Kobayashi
Department of Diagnostic Imaging, Tochigi Cancer Center, Utsunomiya, Japan
,
Manabu Muto
Department of Clinical oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
,
Hajime Takatori
Department of Gastroenterology, Kanazawa University Hospital, Kanazawa, Japan
,
Takashi Abe
Department of Gastroenterology, Takarazuka Municipal Hospital, Takarazuka, Japan
,
Masahiko Tsujii
Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Suita, Japan
,
Jiro Watari
Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan
,
Shuhei Ishiyama
Department of Internal Medicine, Okayama Saiseikai General Hospital, Okayama, Japan
,
Ichiro Oda
Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
,
Hiroyuki Ono
Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
,
Kazuhiro Kaneko
Endoscopy Division, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
,
Chizu Yokoi
Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo, Japan
,
Tetsuya Ueo
Department of Gastroenterology, Oita Red Cross Hospital, Oita, Japan
,
Kunihisa Uchita
Department of Gastroenterology, Kochi Red Cross Hospital, Kochi, Japan
,
Kenshi Matsumoto
Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan
,
Takashi Kanesaka
Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
,
Yoshinori Morita
Division of Gastroenterology, Department of Internal Medicine, Graduate School of Medicine, Kobe University, Kobe, Japan
,
Shinichi Katsuki
Center of Gastroenterology, Otaru Ekisaikai Hospital, Otaru, Japan
,
Jun Nishikawa
Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Ube, Japan
,
Katsuhisa Inamura
Department of Gastroenterology, Tonami General Hospital, Tonami, Japan
,
Tetsu Kinjo
Department of Endoscopy, University of the Ryukyus, Okinawa, Japan
,
Katsumi Yamamoto
Department of Gastroenterology, Toyonaka Municipal Hospital, Toyonaka, Japan
,
Daisuke Yoshimura
Department of Internal Medicine, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
,
Hiroshi Araki
Division of Endoscopy, Gifu University Hospital, Gifu, Japan
,
Hiroshi Kashida
Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine, Osaka-sayama, Japan
,
Ayumu Hosokawa
Department of Gastroenterology and Hematology, Faculty of Medicine, University of Toyama, Toyama, Japan
,
Hirohito Mori
Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan
,
Haruhiro Yamashita
Department of Gastroenterology, National Hospital Organization Okayama Medical Center, Okayama, Japan
,
Osamu Motohashi
Department of Gastroenterology, Kanagawa Cancer Center, Yokohama, Japan
,
Kazuhiko Kobayashi
Department of Gastroenterology, Matsusaka Chuo General Hospital, Matsusaka, Japan
,
Michiaki Hirayama
Department of Gastroenterological Medicine, Tonan Hospital, Sapporo, Japan
,
Hiroyuki Kobayashi
Division of Gastroenterology, Fukuoka Sanno Hospital, Fukuoka, Japan
,
Masaki Endo
Department of Gastroenterology and Hepatology, School of Medicine, Iwate Medical University, Morioka, Japan
,
Hiroo Yamano
Digestive Disease Center, Akita Red Cross Hospital, Akita, Japan
,
Kazunari Murakami
Department of Gastroenterology, Oita University, Yufu, Japan
,
Tomoyuki Koike
Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
,
Kingo Hirasawa
Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan
,
Youichi Miyaoka
Department of Endoscopy, Shimane Prefectural Central Hospital, Izumo, Japan
,
Hidetaka Hamamoto
Digestive Endoscopy Center, Sendai Kousei Hospital, Sendai, Japan
,
Takuto Hikichi
Department of Endoscopy, Fukushima Medical University Hospital, Fukushima, Japan
,
Norihiro Hanabata
Department of Gastroenterology and Hepatology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
,
Ryo Shimoda
Departments of Internal Medicine and Gastrointestinal Endoscopy, Saga Medical School, Saga, Japan
,
Shinichiro Hori
Department of Endoscopy, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
,
Tadashi Sato
Department of Gastroenterology and Division of Endoscopy, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
,
Shinya Kodashima
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Hiroyuki Okada
Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
,
Tomohiko Mannami
Department of Gastroenterology, Chugoku Central Hospital, Fukuyama, Japan
,
Shojiro Yamamoto
Division of Gastroenterology and Hematology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
,
Yasumasa Niwa
Departments of Endoscopy, Aichi Cancer Center Hospital, Nagoya, Japan
,
Kazuo Yashima
Department of Gastroenterology, Tottori University Hospital, Yonago, Japan
,
Satoshi Tanabe
Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Japan
,
Hiro Satoh
Department of Gastroenterology, Yokohama Sakae Kyosai Hospital, Yokohama, Japan
,
Fumisato Sasaki
Department of Gastroenterology, Kagoshima University Medical and Dental Hospital, Kagoshima, Japan
,
Tetsuro Yamazato
Department of Gastroenterology, Tokyo Metropolitan Cancer Detection Center, Tokyo, Japan
,
Yoshiou Ikeda
Endoscopy Center, Ehime University Hospital, Toon, Japan
,
Hogara Nishisaki
Department of Gastroenterological Oncology, Hyogo Cancer Center, Hyogo, Japan
,
Masahiro Nakagawa
Department of Internal Medicine, Hiroshima City Hospital, Hiroshima, Japan
,
Akio Matsuda
Department of Gastroenterology, Nanpuh Hospital, Kagoshima, Japan
,
Fumio Tamura
Division of Gastroenterology, Kumamoto Regional Medical Center, Kumamoto, Japan
,
Hitoshi Nishiyama
Department of Gastroenterology, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan
,
Keiko Arita
Arita Gastro-intestinal Hospital, Oita, Japan
,
Keisuke Kawasaki
Division of Gastroenterology, Matsuyama Red Cross Hospital, Matsuyama, Japan
,
Kazushige Hoppo
Division of Gastroenterology, Yamatotakada Municipal Hospital, Yamatotakada, Japan
,
Masashi Oka
Department of Gastroenterology and Hepatology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
,
Shinichi Ishihara
Ishihara Gastroenterology Clinic, Zentsuji, Japan
,
Michita Mukasa
Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Fukuoka, Japan
,
Hiroaki Minamino
Department of Gastroenterology, Izumiotsu Municipal Hospital, Izumiotsu, Japan
,
Kenshi Yao
Department of Endoscopy, Fukuoka University Chikushi Hospital, Fukuoka, Japan
› Author Affiliations
Further Information

Publication History

submitted 07 December 2016

accepted after revision 01 May 2017

Publication Date:
21 June 2017 (eFirst)

Abstract

Background and study aim Magnifying narrow-band imaging (M-NBI) is useful for the accurate diagnosis of early gastric cancer (EGC). However, acquiring skill at M-NBI diagnosis takes substantial effort. An Internet-based e-learning system to teach endoscopic diagnosis of EGC using M-NBI has been developed. This study evaluated its effectiveness.

Participants and methods This study was designed as a multicenter randomized controlled trial. We recruited endoscopists as participants from all over Japan. After completing Test 1, which consisted of M-NBI images of 40 gastric lesions, participants were randomly assigned to the e-learning or non-e-learning groups. Only the e-learning group was allowed to access the e-learning system. After the e-learning period, both groups received Test 2. The analysis set was participants who scored < 80 % accuracy on Test 1. The primary end point was the difference in accuracy between Test 1 and Test 2 for the two groups.

Results A total of 395 participants from 77 institutions completed Test 1 (198 in the e-learning group and 197 in the non-e-learning group). After the e-learning period, all 395 completed Test 2. The analysis sets were e-learning group: n = 184; and non-e-learning group: n = 184. The mean Test 1 score was 59.9 % for the e-learning group and 61.7 % for the non-e-learning group. The change in accuracy in Test 2 was significantly higher in the e-learning group than in the non-e-learning group (7.4 points vs. 0.14 points, respectively; P < 0.001).

Conclusion This study clearly demonstrated the efficacy of the e-learning system in improving practitioners’ capabilities to diagnose EGC using M-NBI.

Trial registered at University Hospital Medical Information Network Clinical Trials Registry (UMIN000008569).