Development and validation of an endoscopic submucosal dissection video assessment tool

Area of Science:

• Gastroenterology
• Surgical Education
• Medical Device Development

Background:

• Lack of structured assessment tools for endoscopic submucosal dissection (ESD) skills hinders progress tracking and competence determination.
• Existing methods do not adequately evaluate the complex skills required for ESD performance.
• A validated tool is needed to objectively assess ESD competency.

Purpose of the Study:

• To develop and validate an assessment tool for evaluating recorded endoscopic submucosal dissection (ESD) performance for gastric neoplasms.
• To establish the reliability and validity of the ESD Video Assessment Tool (EVAT).
• To provide a structured measure for assessing ESD competency.

Main Methods:

• Systematic development of the ESD Video Assessment Tool (EVAT) by experienced endoscopists, comprising a 25-item global rating scale and a 3-item checklist.
• Assessment of inter-rater reliability using intraclass correlation coefficients (ICC) on 5 videos evaluated by 2 blinded endoscopists.
• Examination of validity evidence by comparing scores between inexperienced (fellows) and experienced (attending) endoscopists, and correlating scores with ESD case experience. Internal consistency was assessed using Cronbach's alpha.

Main Results:

• High inter-rater reliability for the total EVAT score (ICC = 0.87).
• Significant differences in total scores between inexperienced (median 71) and experienced endoscopists (median 95) (P=0.005).
• Strong correlation between EVAT scores and ESD case experience (Spearman's ρ = 0.79, P < 0.01). High internal consistency (Cronbach's alpha = 0.97).

Conclusions:

• The ESD Video Assessment Tool (EVAT) demonstrates preliminary validity evidence for assessing video-recorded ESD performances in gastric neoplasms.
• EVAT provides a reliable and valid method for evaluating ESD skills.
• This tool can aid in tracking progress and determining competence in ESD.