Web-based system for training and dissemination of a magnification chromoendoscopy classification

作     者：Mário Jorge Dinis-Ribeiro Ricardo Cruz Correia Cristina Santos Sónia Fernandes Ernesto Palhares Rui Almeida Silva Pedro Amaro Miguel Areia Altamiro Costa-Pereira Luis Moreira-Dias 

作者机构：Gastroenterology DepartmentPortuguese Oncology Institute Center for Research in Information Systems and Health Technologies (CINTESIS)/Department of Biostatistics and Medical InformaticsPorto Faculty of Medicine Gastroenterology DepartmentCoimbra University Hospital 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2008年第14卷第46期

页      面：7086-7092页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：Sociedade Portuguesa de Endoscopia Digestiva (Research Grant 2002) the European Society for Gastrointestinal Endoscopy 

主　　题：Magnification Chromoendoscopy Reproducibility Learning curve 

摘      要：AIM： To evaluate the use of web-based technologies to assess the learning curve and reassess reproducibility of a simplified version of a classification for gastric magnification chromoendoscopy （MC）. METHODS： As part of a multicenter trial, a hybrid approach was taken using a CD-ROM, with 20 films of MC lasting 5 s each and an ＂autorun＂ file triggering a local HTML frameset referenced to a remote questionnaire through an Internet connection. Three endoscopists were asked to prospectively and independently classify 10 of these films randomly selected with at least 3 d apart. The answers were centrally stored and returned to participants together with adequate feedback with the right answer. RESULTS： For classification in 3 groups, both intra- [Cohen＇s kappa （K） = 0.79-1.00 to 0.89-1.00] and inter-observer agreement increased from 1st （moderate） to 6th observation （k = 0.94）. Also, agreement with reference increased in the last observations （0.90, 1.00 and 1.00, for observers A, B and C, respectively）. Validity of 100% was obtained by all observers at their 4th observation. When a 4th （sub）group was considered, inter-observer agreement was almost perfect （K = 0.92） at 6th observation. The relation with reference clearly improved into K （0.93-1.00） and sensitivity （75%-100%） at their 6th observations. CONCLUSION： This MC classification seems to be easily explainable and learnable as shown by excellent intra- and inter-observer agreement, and improved agreement with reference. A web system such as the one used in this study may be useful for endoscopic or other image based diagnostic procedures with respect to definition, education and dissemination.