Evaluation of an e-learning system for diagnosis of gastric lesions using magnifying narrow-band imaging: a multicenter randomized controlled study
Authors: Hiroyoshi Nakanishi, Hisashi Doyama, Hideki Ishikawa, Noriya Uedo, Takuji Gotoda, Mototsugu Kato, Shigeaki Nagao, Yasuaki Nagami, Hiroyuki Aoyagi, Atsushi Imagawa, Junichi Kodaira, Shinya Mitsui, Nozomu Kobayashi, Manabu Muto, Hajime Takatori, Takashi Abe, Masahiko Tsujii, Jiro Watari, Shuhei Ishiyama, Ichiro Oda, Hiroyuki Ono, Kazuhiro Kaneko, Chizu Yokoi, Tetsuya Ueo, Kunihisa Uchita, Kenshi Matsumoto, Takashi Kanesaka, Yoshinori Morita, Shinichi Katsuki, Jun Nishikawa, Katsuhisa Inamura, Tetsu Kinjo, Katsumi Yamamoto, Daisuke Yoshimura, Hiroshi Araki, Hiroshi Kashida, Ayumu Hosokawa, Hirohito Mori, Haruhiro Yamashita, Osamu Motohashi, Kazuhiko Kobayashi, Michiaki Hirayama, Hiroyuki Kobayashi, Masaki Endo, Hiroo Yamano, Kazunari Murakami, Tomoyuki Koike, Kingo Hirasawa, Youichi Miyaoka, Hidetaka Hamamoto, Takuto Hikichi, Norihiro Hanabata, Ryo Shimoda, Shinichiro Hori, Tadashi Sato, Shinya Kodashima, Hiroyuki Okada, Tomohiko Mannami, Shojiro Yamamoto, Yasumasa Niwa, Kazuo Yashima, Satoshi Tanabe, Hiro Satoh, Fumisato Sasaki, Tetsuro Yamazato, Yoshiou Ikeda, Hogara Nishisaki, Masahiro Nakagawa, Akio Matsuda, Fumio Tamura, Hitoshi Nishiyama, Keiko Arita, Keisuke Kawasaki, Kazushige Hoppo, Masashi Oka, Shinichi Ishihara, Michita Mukasa, Hiroaki Minamino, Kenshi Yao
Journal: Endoscopy (2017)

Background and study aim Magnifying narrow-band imaging (M-NBI) is useful for the accurate diagnosis of early gastric cancer (EGC). However, acquiring skill at M-NBI diagnosis takes substantial effort. An Internet-based e-learning system to teach endoscopic diagnosis of EGC using M-NBI has been developed. This study evaluated its effectiveness. Participants and methods This study was designed as a multicenter randomized controlled trial. We recruited endoscopists as participants from all over Japan. After completing Test 1, which consisted of M-NBI images of 40 gastric lesions, participants were randomly assigned to the e-learning or non-e-learning groups. Only the e-learning group was allowed to access the e-learning system. After the e-learning period, both groups received Test 2. The analysis set was participants who scored < 80 % accuracy on Test 1. The primary end point was the difference in accuracy between Test 1 and Test 2 for the two groups. Results A total of 395 participants from 77 institutions completed Test 1 (198 in the e-learning group and 197 in the non-e-learning group). After the e-learning period, all 395 completed Test 2. The analysis sets were e-learning group: n = 184; and non-e-learning group: n = 184. The mean Test 1 score was 59.9 % for the e-learning group and 61.7 % for the non-e-learning group. The change in accuracy in Test 2 was significantly higher in the e-learning group than in the non-e-learning group (7.4 points vs. 0.14 points, respectively; P < 0.001). Conclusion This study clearly demonstrated the efficacy of the e-learning system in improving practitioners' capabilities to diagnose EGC using M-NBI.Trial registered at University Hospital Medical Information Network Clinical Trials Registry (UMIN000008569).