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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.
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.
- 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.
