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. 2023 Feb;68(2):616-622.
doi: 10.1007/s10620-022-07643-0. Epub 2022 Aug 10.

Accuracy and Inter-observer Agreement Among Endoscopists for Visual Identification of Colorectal Polyps Using Endoscopy Images

Thi Khuc  1   2 , Amol Agarwal  3   4 , Feng Li  3 , Sergey Kantsevoy  3 , Bryan Curtin  3 , Matilda Hagan  3   4 , Mary Harris  3 , Anurag Maheshwari  3   4 , Amit Raina  3 , Elinor Zhou  3 , Paul Thuluvath  3   4
Affiliations

Accuracy and Inter-observer Agreement Among Endoscopists for Visual Identification of Colorectal Polyps Using Endoscopy Images

Thi Khuc et al. Dig Dis Sci. 2023 Feb.

Abstract

Background: It is essential to accurately distinguish small benign hyperplastic colon polyps (HP) from sessile serrated lesions (SSL) or adenomatous polyps (TA) based on endoscopic appearances. Our objective was to determine the accuracy and inter-observer agreements for the endoscopic diagnosis of small polyps.

Methods: High-quality endoscopic images of 30 small HPs, SSLs, and TAs were used randomly to create two-timed PowerPoint slide sets-one with and another one without information on polyp size and location. Seven endoscopists viewed the slides on two separate occasions 90 days apart, identified the polyp type, and graded their confidence level. Overall and polyp-specific accuracies were assessed for the group and individual endoscopists. Chi-square tests and Kappa (κ) statistics were used to compare differences as appropriate.

Results: When polyp size and location were provided, overall accuracy was 67.1% for TAs, 50.0% for SSLs, and 41.4% for HPs; the corresponding accuracies were 60%, 44.3%, and 34.3% when polyp size and location were withheld (p < .001). Inter-observer agreement was moderate for TAs (κ = 0.50) and fair for SSLs (κ = 0.26) and HPs (κ = 0.29); the corresponding inter-observer agreements were 0.44, 0.31, and 0.17 with polyp size and location withheld. Accuracy was not affected by knowledge of polyp size, location, or confidence level. Endoscopists with ≥ 10 years (vs. < 10 years) of colonoscopy experience had marginally higher (56% vs. 40%, p = 0.05) accuracy for SSL diagnosis.

Conclusions: The ability to distinguish between small TAs, SSLs, and HPs on their endoscopic appearance is poor regardless of the endoscopists' knowledge of polyp size and location.

Keywords: Endoscopic identification; Hyperplastic polyps; Sessile serrated lesions; Tubular adenoma; Visual accuracy.

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References

    1. Zauber AG, Winawer SJ, O’Brien MJ et al. Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths. N Engl J Med. 2012;366:687–696. - DOI
    1. Kaltenbach T, Anderson JC, Burke CA et al. Endoscopic Removal of Colorectal Lesions: Recommendations by the US Multi-Society Task Force on Colorectal Cancer. Am J Gastroenterol. 2020;115:435–464. - DOI
    1. Wang FW, Hsu PI, Chuang HY et al. Prevalence and risk factors of asymptomatic colorectal polyps in Taiwan. Gastroenterol Res Pract. 2014;2014:985205. - DOI
    1. Spring KJ, Zhao ZZ, Karamatic R et al. High prevalence of sessile serrated adenomas with BRAF mutations: a prospective study of patients undergoing colonoscopy. Gastroenterology. 2006;131:1400–1407. - DOI
    1. Crockett SD, Nagtegaal ID. Terminology, Molecular Features, Epidemiology, and Management of Serrated Colorectal Neoplasia. Gastroenterology. 2019;157:949–966. - DOI

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