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CC BY-NC-ND 4.0 · Endosc Int Open 2019; 07(07): E871-E882
DOI: 10.1055/a-0902-4467
Original article
Owner and Copyright © Georg Thieme Verlag KG 2019

Self-study of the non-extension sign in an e-learning program improves diagnostic accuracy of invasion depth of early gastric cancer

Minoru Kato
 1   Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
,
Noriya Uedo
 1   Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
,
Takashi Nagahama
 2   Department of Endoscopy, Fukuoka University Chikushi Hospital, Chikushino, Japan
,
Kenshi Yao
 2   Department of Endoscopy, Fukuoka University Chikushi Hospital, Chikushino, Japan
,
Hisashi Doyama
 3   Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
,
Shigetsugu Tsuji
 3   Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
,
Takuji Gotoda
 4   Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
,
Takuji Kawamura
 5   Department of Gastroenterology, Kyoto Second Red Cross Hospital, Kyoto, Japan
,
Masahide Ebi
 6   Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
,
Katsumi Yamamoto
 7   Department of Gastroenterology, Japan Community Healthcare Organization, Osaka Hospital, Osaka, Japan
,
Tomofumi Akasaka
 8   Department of Gastroenterology and Hepatology, National Hospital Organization Osaka National Hospital, Osaka, Japan
,
Hajime Takatori
 9   Department of gastroenterology, Kanazawa University Hospital, Kanazawa, Japan
,
Osamu Handa
10   Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
,
Takuji Akamatsu
11   Department of Gastroenterology and Hepatology, Japanese Red Cross Society Wakayama Medical Center, Wakayama, Japan
,
Jun Nishikawa
12   Department of Laboratory Science, Yamaguchi University Graduate School of Medicine, Ube, Japan
,
Takuto Hikichi
13   Department of Endoscopy, Fukushima Medical University Hospital, Fukushima, Japan
,
Takeshi Yamashina
14   Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
,
Akira Imoto
15   Second Department of Internal Medicine, Osaka Medical College, Takatsuki, Japan
,
Yoko Kitamura
16   Center for Digestive and Liver Disease, Department of Gastroenterology, Nara City Hospital, Nara, Japan
,
Tatsuya Mikami
17   Division of Endoscopy, Hirosaki University Hospital, Hirosaki, Japan
,
Tomoyuki Koike
18   Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
,
Shuichi Ohara
19   Department of Gastroenterology, Tohoku Rosai Hospital, Sendai, Japan
,
Shinji Kitamura
20   Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
,
Tatsuya Yamaguchi
21   First Department of Internal Medicine, University of Yamanashi, Yamanashi, Japan
,
Tetsu Kinjo
22   Department of Endoscopy, University of the Ryukyus Hospital, Okinawa, Japan
,
Taro Inoue
23   Department of Gastroenterology and Hepatology, Kishiwada Tokushukai Hospital, Kishiwada, Japan
,
Sho Suzuki
24   Department of Gastroenterology and Hepatology, Center for Digestive Disease, and Division of Endoscopy, University of Miyazaki Hospital, Miyazaki, Japan
,
Akihiro Kaneko
25   Department of Gastroenterological Medicine, Kobe Rosai Hospital, Kobe, Japan
,
Kingo Hirasawa
26   Division of Endoscopy, Yokohama City University Medical Center, Yokohama, Japan
,
Kyosuke Tanaka
27   Department of Endoscopy, Mie University Hospital, Tsu, Japan
,
Takahiro Kotachi
28   Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan
,
Kazuhiro Miwa
29   Department of Gastroenterology, Komatsu Municipal Hospital, Komatsu, Japan
,
Yosuke Toya
30   Department of Gastroenterology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Morioka, Japan
,
Shoichi Kayaba
31   Department of Gastroenterology, Iwate Prefectural Isawa Hospital, Ohshu, Japan
,
Atsushi Ikehata
32   Department of Gastroenterology, Iwate Prefectural Central Hospital, Morioka, Japan
,
Shinya Minami
33   Department of Gastroenterology, Oji General Hospital, Tomakomai, Japan
,
Kazuhiro Mizukami
34   Department of Gastroenterology, Oita University, Yufu, Oita, Japan
,
Hirohisa Oya
35   Department of Gastroenterology and Hepatology, Saiseikai Suita Hospital, Suita, Japan
,
Nobuyuki Ara
36   Department of Gastroenterology, National Hospital Organization Sendai Medical Hospital, Sendai, Japan
,
Yasushi Fukumoto
37   Department of Gastroenterology, National Hospital Organization Okayama Medical Center, Okayama, Japan
,
Takuya Komura
38   Department of Gastroenterology, National Hospital Organization Kanazawa Medical Center, Kanazawa, Japan
,
Toshiyuki Yoshio
39   Department of Gastroenterology, Cancer Institute Hospital, Tokyo, Japan
,
Ryutaro Morizono
40   Section of Gastroenterology, Department of Internal Medicine, Kin-ikyo Chuo Hospital, Sapporo, Japan
,
Kenji Yamazaki
41   Department of Gastroenterology, Gifu Prefectural General Medical Center, Gifu, Japan
,
Yuichi Shimodate
42   Department of Gastroenterology and Hepatology, Kurashiki Central Hospital, Kurashiki, Japan
,
Kohei Yamanouchi
43   Department of Gastroenterology, Takagi Hospital, Okawa, Japan
,
Noboru Kawata
44   Division of Endoscopy, Shizuoka Cancer Center, Nagaizumi-cho Sunto-gun, Japan
,
Masayuki Kumagai
45   Department of Gastroenterology, Yokkaichi Municipal Hospital, Yokkaichi, Japan
,
Yoshinori Sato
46   Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
,
Kiyotaka Umeki
47   Department of Gastroenterology, Chiba-Nishi General Hospital, Matsudo, Japan
,
Daisuke Kawai
48   Department of Gastroenterology, Tsuyama Chuo Hospital, Tsuyama, Japan
,
Tokuma Tanuma
49   Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
,
Maiko Kishino
50   Department of Gastroenterology, Tokyo Womenʼs Medical University Hospital, Tokyo, Japan
,
Jun Konishi
51   Department of Gastroenterology, Tochigi Cancer Center, Utsunomiya, Japan
,
Tetsuya Sumiyoshi
52   Department of Gastroenterology, Tonan Hospital, Sapporo, Japan
,
Shohei Oka
53   Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
,
Mitsuhiro Kono
54   Department of Gastroenterology, Higashisumiyoshi Morimoto Hospital, Osaka, Japan
,
Takeshi Sakamoto
55   Department of Gastroenterological Oncology, Hyogo Cancer Center, Akashi, Japan
,
Yohei Horikawa
56   Department of Gastroenterology, Hiraka General Hospital, Yokote, Japan
,
Motoki Ohyauchi
57   Department of Gastroenterology, Osaki Citizen Hospital, Osaki, Japan
,
Keiichi Hashiguchi
58   Department of Endoscopy, Nagasaki University Hospital, Nagasaki, Japan
,
Yohei Waseda
59   Department of Internal Medicine, Asanogawa General Hospital, Kanazawa, Japan
,
Toyotaka Kasai
60   Department of Gastroenterology, Fukaya Red Cross Hospital, Saitama, Japan
,
Hiroyuki Aoyagi
61   Department of Gastroenterology, Fukui Prefectural Hospital, Fukui, Japan
,
Hirokazu Oyamada
62   Department of Gastroenterology, Matsushita Memorial Hospital, Moriguchi, Japan
,
Masakuni Shoji
63   Department of Gastroenterology, Faculty of Medicine, Yamagata University, Yamagata, Japan
,
Shu Kiyotoki
64   Department of Gastroenterology, Shuto General Hospital, Yanai, Japan
,
Sho Asonuma
65   Department of Gastroenterology, South Miyagi Medical Center, Shibata-gun, Japan
,
Shunsuke Orikasa
66   Department of Gastroenterology, Iwate Prefectural Kuji Hospital, Kuji, Japan
,
Chika Akaishi
67   Department of Gastroenterology, Iwate Prefectural Chubu Hospital, Kitakami, Japan
,
Yasuaki Nagami
68   Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
,
Satoshi Nakata
69   Department of Gastroenterology, Rakuwakai Otowa Hospital, Kyoto, Japan
,
Fumiyo Iida
70   Department of Gastroenterology, Japan Community Healthcare Organization, Kanazawa Hospital, Kanazawa, Japan
,
Tatsuma Nomura
71   Department of Gastroenterology, Kinan Hospital, Minamimuro, Mie, Japan
,
Kei Tominaga
72   Department of Gastroenterology, Kaga Medical Center, Kaga, Japan
,
Kohei Oka
73   Department of Gastroenterology and Hepatology, North Medical Center, Kyoto Prefectural University of Medicine, Yosa, Japan
,
Yoshinori Morita
74   Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
,
Haruhisa Suzuki
75   Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
,
Keiji Ozeki
76   Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
,
Shiko Kuribayashi
77   Clinical Investigation and Research Unit, Gunma University Hospital, Maebashi, Japan
,
Yoichi Akazawa
78   Department of Gastroenterology, Juntendo University, School of Medicine, Tokyo, Japan
,
Sho Sasaki
79   Department of Gastroenterology, Tokuyama Central Hospital, Shunan, Japan
,
Tetsuhiko Mikami
80   Department of Gastroenterology, Towada City Hospital, Towada, Japan
,
Goro Miki
81   Department of Gastroenterology, Nobeoka Medical Association Hospital, Nobeoka, Japan
,
Tatsushi Sano
82   Department of Gastroenterology, Moriguchi Keijinkai Hospital, Moriguchi, Japan
,
Hiro Satoh
83   Department of Gastroenterology, Midori Municipal Hospital, Nagoya, Japan
,
Munetaka Nakamura
84   Department of Gastroenterology, Hagi Civil Hospital, Hagi, Japan
,
Wataru Iwai
85   Department of Gastroenterology, Miyagi Cancer Center, Natori, Japan
,
Hideki Tawa
86   Department of Gastroenterology, Seikeikai Hospital, Sakai, Japan
,
Masafumi Wada
87   Department of Gastroenterology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
,
Daisuke Yoshimura
88   Division of Gastroenterology, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
,
Yasuhiro Hisanaga
89   Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan
,
Toshio Shimokawa
90   Department of Clinical Study Support Center, Wakayama Medical University, Wakayama, Japan
,
Hideki Ishikawa
91   Department of Molecular-Targeting Cancer Prevention, Kyoto Prefectural University of Medicine, Kyoto, Japan
› Author Affiliations
Further Information

Publication History

submitted 10 November 2018

accepted after revision 01 April 2019

Publication Date:
03 July 2019 (online)

Also available at
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Referred to by:

Should we recommend use of non-extension sign in Europe?Endosc Int Open 2019; 07(07): E883-E884
DOI: 10.1055/a-0889-7987

Abstract

Background and study aims We developed an e-learning program for endoscopic diagnosis of invasion depth of early gastric cancer (EGC) using a simple diagnostic criterion called non-extension sign, and the contribution of self-study quizzes to improvement of diagnostic accuracy was evaluated.

Methods We conducted a prospective randomized controlled study that recruited endoscopists throughout Japan. After completing a pretest, the participants watched video lectures and undertook post-test 1. The participants were then randomly allocated to either the self-study or non-self-study group, and participants in the first group completed the self-study program that comprised 100-case quizzes. Finally, participants in both groups undertook post-test 2. The primary endpoint was the difference in post-test 2 scores between the groups. The perfect score for the tests was set as 100 points.

Results A total of 423 endoscopists completed the pretest and were enrolled. Post-test 1 was completed by 415 endoscopists and 208 were allocated to the self-study group and 207 to the non-self-study group. Two hundred and four in the self-study group and 205 in the non-self-study group were included in the analysis. Video lectures improved the mean score of post-test 1 from 72 to 77 points. Participants who completed the self-study quizzes showed significantly better post-test 2 scores compared with the non-self-study group (80 vs. 76 points, respectively, P < 0.0001).

Conclusions Our e-learning program showed that self-study quizzes consolidated knowledge of the non-extension sign and improved diagnostic ability of endoscopists for invasion depth of EGC.

Comment to this article:

Endoscopy International Open – recently publishedEndoscopy 2019; 51(08): 800-800
DOI: 10.1055/a-0919-7696

 

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