Evidence map›Paper›PMID 32739484›Full record

ArticleGastrointestinal endoscopy2021

Development and initial validation of an instrument for video-based assessment of technical skill in ERCP.

B Joseph Elmunzer, Catharine M Walsh, Gretchen Guiton, Jose Serrano, Amitabh Chak, Steven Edmundowicz, Richard S Kwon, Daniel Mullady, Georgios I Papachristou, Grace Elta and 16 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Gastrointestinal endoscopy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed.

  1. Article
  2. Article
  3. Advanced Endoscopy: Future Training Perspectives and Tracks.Current gastroenterology reports · 2025
    Review
  4. Video recording in GI endoscopy.VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy · 2025
    Article
  5. Article
  6. Article
  7. The use of simulators to acquire ERCP skills: a systematic review.Annals of medicine and surgery (2012) · 2023
    Article
  8. Article
  9. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

26 authors.

B Joseph ElmunzerDivision of Gastroenterology and Hepatology, Medical University of South Carolina, Charleston, South Carolina, USA.
Catharine M WalshDivision of Gastroenterology, Hepatology, and Nutrition, Learning Institute and Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada.
Gretchen GuitonDepartment of Internal Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA.
Jose SerranoNational Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA.
Amitabh ChakDivision of Gastroenterology and Liver Disease, Case Western Reserve University, Cleveland, Ohio, USA.
Steven EdmundowiczDivision of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
Richard S KwonDivision of Gastroenterology, University of Michigan, Ann Arbor, Michigan, USA.
Daniel MulladyDivision of Gastroenterology, Washington University School of Medicine, St Louis, Missouri, USA.
Georgios I PapachristouDivision of Gastroenterology, Hepatology, and Nutrition, Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
Grace EltaDivision of Gastroenterology, University of Michigan, Ann Arbor, Michigan, USA.
Todd H BaronDivision of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina, USA.
Patrick YachimskiDivision of Gastroenterology, Vanderbilt University, Nashville, Tennessee, USA.
Evan L FogelDivision of Gastroenterology and Hepatology, Indiana University, Indianapolis, Indiana, USA.
Peter V DraganovDivision of Gastroenterology, Hepatology, and Nutrition, University of Florida, Gainesville, Florida, USA.
Jason R TaylorDivision of Gastroenterology and Hepatology, St Louis University, St Louis, Missouri, USA.
James ScheimanDivision of Gastroenterology and Hepatology, University of Virginia, Charlottesville, Virginia, USA.
Vikesh K SinghDivision of Gastroenterology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Shyam VaradarajuluCenter for Interventional Endoscopy, Advent Health, Orlando, Florida, USA.
Field F WillinghamDivision of Digestive Diseases, Emory University, Atlanta, Georgia, USA.
Gregory A CoteDivision of Gastroenterology and Hepatology, Medical University of South Carolina, Charleston, South Carolina, USA.
Peter B CottonDivision of Gastroenterology and Hepatology, Medical University of South Carolina, Charleston, South Carolina, USA.
Violette SimonDivision of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
Rebecca SpitzerDivision of Gastroenterology and Hepatology, Medical University of South Carolina, Charleston, South Carolina, USA.
Rajesh KeswaniDivision of Gastroenterology, Northwestern University, Chicago, Illinois, USA.
Sachin WaniDivision of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
SVI study group and the U.S. Cooperative for Outcomes Research in Endoscopy

Funding

Stent vs. Indomethacin for Preventing Post-ERCP Pancreatitis: The SVI TrialU01DK104833 · NIDDK · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI ELMUNZER, BADIH JOSEPH · 2015 to 2020
$11.5M
Proteomics CoreP30DK123704 · NIDDK · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI DON C. ROCKEY · 2020 to 2026
$8.8M
NIDDK NIH HHS P30 DK123704NIDDK NIH HHS U01 DK104833
6 · The paper itself

Abstract

BACKGROUND AND

aimsThe accurate measurement of technical skill in ERCP is essential for endoscopic training, quality assurance, and coaching of this procedure. Hypothesizing that technical skill can be measured by analysis of ERCP videos, we aimed to develop and validate a video-based ERCP skill assessment tool.

methodsBased on review of procedural videos, the task of ERCP was deconstructed into its basic components by an expert panel that developed an initial version of the Bethesda ERCP Skill Assessment Tool (BESAT). Subsequently, 2 modified Delphi panels and 3 validation exercises were conducted with the goal of iteratively refining the tool. Fully crossed generalizability studies investigated the contributions of assessors, ERCP performance, and technical elements to reliability.

resultsTwenty-nine technical elements were initially generated from task deconstruction. Ultimately, after iterative refinement, the tool comprised 6 technical elements and 11 subelements. The developmental process achieved consistent improvements in the performance characteristics of the tool with every iteration. For the most recent version of the tool, BESAT-v4, the generalizability coefficient (a reliability index) was .67. Most variance in BESAT scores (43.55%) was attributed to differences in endoscopists' skill, indicating that the tool can reliably differentiate between endoscopists based on video analysis.

conclusionsVideo-based assessment of ERCP skill appears to be feasible with a novel instrument that demonstrates favorable validity evidence. Future steps include determining whether the tool can discriminate between endoscopists of varying experience levels and predict important outcomes in clinical practice.

Indexed as

Cholangiopancreatography, Endoscopic RetrogradeClinical CompetenceHumansReproducibility of Results

Identifiers

PMID32739484
PMCPMC8961206

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.