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Learning Curve and Interobserver Agreement of Confocal Laser Endomicroscopy for Detecting Precancerous or Early-Stage Esophageal Squamous Cancer
BACKGROUND: Confocal laser endomicroscopy (CLE) can provide in vivo subcellular resolution images of esophageal lesions. However, the learning curve in interpreting CLE images of precancerous or early-stage esophageal squamous cancer is unknown. The goal of this study is to evaluate the diagnostic a...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4045985/ https://www.ncbi.nlm.nih.gov/pubmed/24897112 http://dx.doi.org/10.1371/journal.pone.0099089 |
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author | Liu, Jing Li, Ming Li, Zhen Zuo, Xiu-Li Li, Chang-Qing Dong, Yan-Yan Zhou, Cheng-Jun Li, Yan-Qing |
author_facet | Liu, Jing Li, Ming Li, Zhen Zuo, Xiu-Li Li, Chang-Qing Dong, Yan-Yan Zhou, Cheng-Jun Li, Yan-Qing |
author_sort | Liu, Jing |
collection | PubMed |
description | BACKGROUND: Confocal laser endomicroscopy (CLE) can provide in vivo subcellular resolution images of esophageal lesions. However, the learning curve in interpreting CLE images of precancerous or early-stage esophageal squamous cancer is unknown. The goal of this study is to evaluate the diagnostic accuracy and inter-observer agreement for differentiating esophageal lesions in CLE images among experienced and inexperienced observers and to assess the learning curve. METHOD: After a short training, 8 experienced and 14 inexperienced endoscopists evaluated in sequence 4 sets of high-quality CLE images. Their diagnoses were corrected and discussed after each set. For each image, the diagnostic results, confidence in diagnosis, quality and time to evaluate were recorded. RESULTS: Overall, diagnostic accuracy was greater for the second, third, fourth set of images as compared with the initial set (odds ratio [OR] 2.01, 95% CI 1.22–3.31; 7.95, 3.74–16.87; and 6.45, 3.14–13.27), respectively, with no difference between the third and fourth sets in accuracy (p = 0.67). Previous experience affected the diagnostic accuracy only in the first set of images (OR 3.70, 1.87–7.29, p<0.001). Inter-observer agreement was higher for experienced than inexperienced endoscopists (0.732 vs. 0.666, p<0.01) CONCLUSION: CLE is a promising technology that can be quickly learned after a short training period; previous experience is associated with diagnostic accuracy only at the initial stage of learning. |
format | Online Article Text |
id | pubmed-4045985 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-40459852014-06-09 Learning Curve and Interobserver Agreement of Confocal Laser Endomicroscopy for Detecting Precancerous or Early-Stage Esophageal Squamous Cancer Liu, Jing Li, Ming Li, Zhen Zuo, Xiu-Li Li, Chang-Qing Dong, Yan-Yan Zhou, Cheng-Jun Li, Yan-Qing PLoS One Research Article BACKGROUND: Confocal laser endomicroscopy (CLE) can provide in vivo subcellular resolution images of esophageal lesions. However, the learning curve in interpreting CLE images of precancerous or early-stage esophageal squamous cancer is unknown. The goal of this study is to evaluate the diagnostic accuracy and inter-observer agreement for differentiating esophageal lesions in CLE images among experienced and inexperienced observers and to assess the learning curve. METHOD: After a short training, 8 experienced and 14 inexperienced endoscopists evaluated in sequence 4 sets of high-quality CLE images. Their diagnoses were corrected and discussed after each set. For each image, the diagnostic results, confidence in diagnosis, quality and time to evaluate were recorded. RESULTS: Overall, diagnostic accuracy was greater for the second, third, fourth set of images as compared with the initial set (odds ratio [OR] 2.01, 95% CI 1.22–3.31; 7.95, 3.74–16.87; and 6.45, 3.14–13.27), respectively, with no difference between the third and fourth sets in accuracy (p = 0.67). Previous experience affected the diagnostic accuracy only in the first set of images (OR 3.70, 1.87–7.29, p<0.001). Inter-observer agreement was higher for experienced than inexperienced endoscopists (0.732 vs. 0.666, p<0.01) CONCLUSION: CLE is a promising technology that can be quickly learned after a short training period; previous experience is associated with diagnostic accuracy only at the initial stage of learning. Public Library of Science 2014-06-04 /pmc/articles/PMC4045985/ /pubmed/24897112 http://dx.doi.org/10.1371/journal.pone.0099089 Text en © 2014 Liu et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Liu, Jing Li, Ming Li, Zhen Zuo, Xiu-Li Li, Chang-Qing Dong, Yan-Yan Zhou, Cheng-Jun Li, Yan-Qing Learning Curve and Interobserver Agreement of Confocal Laser Endomicroscopy for Detecting Precancerous or Early-Stage Esophageal Squamous Cancer |
title | Learning Curve and Interobserver Agreement of Confocal Laser Endomicroscopy for Detecting Precancerous or Early-Stage Esophageal Squamous Cancer |
title_full | Learning Curve and Interobserver Agreement of Confocal Laser Endomicroscopy for Detecting Precancerous or Early-Stage Esophageal Squamous Cancer |
title_fullStr | Learning Curve and Interobserver Agreement of Confocal Laser Endomicroscopy for Detecting Precancerous or Early-Stage Esophageal Squamous Cancer |
title_full_unstemmed | Learning Curve and Interobserver Agreement of Confocal Laser Endomicroscopy for Detecting Precancerous or Early-Stage Esophageal Squamous Cancer |
title_short | Learning Curve and Interobserver Agreement of Confocal Laser Endomicroscopy for Detecting Precancerous or Early-Stage Esophageal Squamous Cancer |
title_sort | learning curve and interobserver agreement of confocal laser endomicroscopy for detecting precancerous or early-stage esophageal squamous cancer |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4045985/ https://www.ncbi.nlm.nih.gov/pubmed/24897112 http://dx.doi.org/10.1371/journal.pone.0099089 |
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