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Validity evidence for an objective scoring tool for endoscopic tip control during snare-tip soft coagulation (with

Lobke Desomer¹, Tamás Tornai², Pieter Jan Poortmans³

¹Department of Gastroenterology and Hepatology, AZ Delta Roeselare, Roeselare, Belgium; Department of Gastroenterology and Hepatology, University Hospital Ghent, Ghent, Belgium; Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.

Gastrointestinal Endoscopy

|May 19, 2026

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Summary

A new scoring method for endoscopic tip control using snare-tip soft coagulation (STSC) during endoscopic mucosal resection (EMR) effectively differentiates expert endoscopists from trainees, enhancing objective skill assessment.

Area of Science:

Gastroenterology and Endoscopy
Surgical Skills Assessment
Medical Education Technology

Background:

Objective assessment tools for endoscopic tip control, a crucial skill, are lacking.
Snare-tip soft coagulation (STSC) of post-endoscopic mucosal resection (EMR) defects offers a standardized task for skill evaluation.
This study aimed to develop and validate a scoring method for STSC application.

Purpose of the Study:

To develop and validate an objective, in-vivo scoring method for assessing endoscopic tip control during STSC.
To compare the performance of expert endoscopists with trainees using this novel scoring system.
To gather validity evidence for the STSC scoring method.

Main Methods:

A prospective, single-center observational study involving patients undergoing EMR for large colorectal polyps.

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Live or video observers used a web-tool to classify STSC applications as correct ('on-margin') or incorrect.

Performance was measured by accuracy, speed, and a composite performance index; group differences were analyzed using generalized linear mixed-effects models.

Main Results:

Experts demonstrated significantly higher accuracy (90.0% vs 81.2%) and speed (13.3 vs 9.7 correct hits/minute) compared to trainees.
The composite performance index was significantly higher for experts, indicating superior endoscopic tip control.
Excellent inter-rater reliability was observed for overall impression (ICC=0.98) and accuracy (ICC=0.97).

Conclusions:

A simple, in-vivo, procedure-level score during STSC provides an objective measure of endoscopic tip control.
This scoring method effectively differentiates between expert endoscopists and trainees.
The developed scoring tool holds potential for practical, objective assessment in endoscopic training and practice.