The Accuracy of Human Endoscopic Detection of Submucosal Invasive Cancer in Colorectal Polyps
The Accuracy of Human Endoscopic Detection of Submucosal Invasive Cancer in Colorectal Polyps - Analysis of 739 Individual Assessments of Large Non-pedunculated Colorectal Polyps Using a Novel Clinical Decision Support Tool
Colorectal cancer (CRC) is a leading cause of death in the Western world. It can be effectively prevented by removal of pre-malignant polyps (polypectomy) during colonoscopy. Large (≥20mm) non-pedunculated colorectal polyps (LNPCPs) represent 2-3% of colorectal polyps, and require special attention prior to treatment. If submucosal invasion (SMI) is suspected careful decision making is required to exclude features which unacceptably increase the risk of lymph node metastases and render local treatment (endoscopic) non-curative. Such patients require a multi-disciplinary approach and consideration of surgery +/- systemic therapy.
Recently the endoscopic imaging characteristics which precisely determine the risk of SMI within colon polyps have been elucidated. This suggests endoscopic imaging may be the ideal investigation to stratify the presence and extent of SMI within LNPCP, particularly as it can be applied in real-time at the time of planned endoscopic treatment.
Unfortunately, current classification systems are complex, require extensive training and technology not available in the majority of non-tertiary hospitals. They are therefore underused leading to incorrect decision making and negative patient outcome (e.g piecemeal resection without the chance of endoscopic cure or unnecessary further procedures in referral centres with resultant surgery anyway or surgery for benign disease)
A simple clinical support tool was created, based on well-established parameters (i.e., presence of a demarcated area within a polyp, size of the polyp, Paris classification, location within the colon and granularity) to identify OVERT (visible on the surface) and COVERT (hidden) submucosal invasion (SMI) within LNPCPs. Crucially this tool only uses what is reproducible in the majority of endoscopy units in the Western world (i.e. standard magnification, no extra chromic dyes etc). predict SMI within LNPCPs and we translated it into a single web-based clinical support tool that can be used by every endoscopist (expert and non-expert).
To evaluate the tool, a survey will be send to participants. The survey consist of a 10-minute educational video where the use of the tool will be explained. Then 20 standardised videos of LNPCPs will be shown. Participants are first asked about their first impression regarding the presence of SMI. Then they are redirected to the web-based tool. After filling the required data from a standardised video (45 seconds to minute, no focus on one particular area of the polyp) the score generated by our tool is copied to the participants computer clipboard and then pasted in the survey so that we could analyse it.
研究概览
地位
条件
研究类型
注册 (实际的)
联系人和位置
学习地点
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Ghent、比利时、9000
- UZ Gent
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参与标准
资格标准
适合学习的年龄
- 孩子
- 成人
- 年长者
接受健康志愿者
有资格学习的性别
取样方法
研究人群
描述
Inclusion Criteria:
- Gastrointestinal endoscopic experience (trainees, student, gastroenterologist consult, surgeon)
Exclusion Criteria:
- No connection with endoscopy in gastroenterology
学习计划
研究是如何设计的?
设计细节
研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
---|---|---|
The accuracy of endoscopic assessment as to the risk of SMI within LNPCPs from a standardised endoscopic video, using a novel, freely accessible, web-based simple clinical decision support tool as versus expert opinion.
大体时间:30 minutes
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Can participants, using the tool, identify SMI within LNPCPs?
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30 minutes
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
---|---|---|
The inter-observer agreement of a novel simple clinical decision support tool to determine the risk of SMI within LNPCPs from a standardised endoscopic video as versus expert opinion.
大体时间:30 minutes
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Are participants able to derive characteristic information from polyps (size, Paris classification, granularity, pit/vascular pattern) using a standardised video of LNPCPs
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30 minutes
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合作者和调查者
调查人员
- 首席研究员:David Tate、UZ Gent
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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