Evidence map›Paper›PMID 36649681›Full record

ArticleDigestion2023

A Multicenter Prospective Validation Study on Selective Endoscopic Resection of Sessile Serrated Lesions Using Magnifying Colonoscopy in Clinical Practice.

Daizen Hirata, Hiroshi Kashida, Tsuguhiro Matsumoto, Chikara Ebisutani, Akira Teramoto, Mineo Iwatate, Santa Hattori, Mikio Fujita, Wataru Sano, Yoriaki Komeda and 3 more

Open access · hybridAbstract readMulticenter Study
In one paragraph

Article in Digestion, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.6field-weighted citation impact, top 15% of its field
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

4 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Image enhanced colonoscopy: updates and prospects-a review.Translational gastroenterology and hepatology · 2023
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 5 institutions in 1 country.

Daizen HirataGastrointestinal Center and Institute of Minimally-Invasive Endoscopic Care (iMEC), Sano Hospital, Kobe, Japan.
Hiroshi KashidaDepartment of Gastroenterology and Hepatology, Kindai University, Osakasayama, Osaka, Japan.
Tsuguhiro MatsumotoDepartment of Gastroenterology, Akashi City Hospital, Akashi, Japan.
Chikara EbisutaniDepartment of Gastroenterology, Hyogo Prefectural Kakogawa Medical Center, Kakogawa, Japan.
Akira TeramotoGastrointestinal Center and Institute of Minimally-Invasive Endoscopic Care (iMEC), Sano Hospital, Kobe, Japan.
Mineo IwatateGastrointestinal Center and Institute of Minimally-Invasive Endoscopic Care (iMEC), Sano Hospital, Kobe, Japan.
Santa HattoriGastrointestinal Center and Institute of Minimally-Invasive Endoscopic Care (iMEC), Sano Hospital, Kobe, Japan.
Mikio FujitaGastrointestinal Center and Institute of Minimally-Invasive Endoscopic Care (iMEC), Sano Hospital, Kobe, Japan.
Wataru SanoGastrointestinal Center and Institute of Minimally-Invasive Endoscopic Care (iMEC), Sano Hospital, Kobe, Japan.
Yoriaki KomedaDepartment of Gastroenterology and Hepatology, Kindai University, Osakasayama, Osaka, Japan.
Yasushi SanoGastrointestinal Center and Institute of Minimally-Invasive Endoscopic Care (iMEC), Sano Hospital, Kobe, Japan.
Yoshitaka MurakamiDepartment of Medical Statistics, Toho University, Ota, Tokyo, Japan.
Masatoshi KudoDepartment of Gastroenterology and Hepatology, Kindai University, Osakasayama, Osaka, Japan.
Kindai University · JPAkashi Municipal City Hospital · JPKansai Medical University · JPToho University · JPToyama University Hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionSessile serrated lesions (SSLs) have malignant potential for colorectal cancer in the serrated pathway. Selective endoscopic resection of SSLs would reduce medical costs and procedure-related accidents, but the accurate endoscopic differentiation of SSLs from hyperplastic polyps (HPs) is challenging. To explore the differential diagnostic performance of magnifying colonoscopy in distinguishing SSLs from HPs, we conducted a multicenter prospective validation study in clinical practice.

methodsConsidering the rarity of diminutive SSLs, all lesions ≥6 mm that were detected during colonoscopy and diagnosed as type 1 based on the Japan narrow-band imaging expert team (JNET) classification were included in this study. Twenty expert endoscopists were asked to differentiate between SSLs and HPs with high or low confidence level after conventional and magnifying NBI observation. To examine the validity of selective endoscopic resection of SSLs using magnifying colonoscopy in clinical practice, we calculated the sensitivity of endoscopic diagnosis of SSLs with histopathological findings as comparable reference.

resultsA total of 217 JNET type 1 lesions from 162 patients were analyzed, and 114 lesions were diagnosed with high confidence. The sensitivity of magnifying colonoscopy in detecting SSLs was 79.8% (95% confidence interval [CI]: 74.7-84.4%) overall, and 82.4% (95% CI: 76.1-87.7%) in the high-confidence group. These results showed that the sensitivity of this study was not high enough, even limited in the high-confidence group.

conclusionsAccurate differential diagnosis of SSLs and HPs using magnifying colonoscopy was challenging even for experts. JNET type 1 lesions ≥6 mm are recommended to be resected because selective endoscopic resection has a disadvantage of leaving approximately 20% of SSLs on site.

Indexed as

AdenomaColonic PolypsColorectal NeoplasmsColonoscopyHumansNarrow Band ImagingDifferential diagnosisMulticenter prospective studySelective endoscopic resectionSessile serrated lesions

Identifiers

PMID36649681
PMCPMC10534952
OpenAlexW4317033234

What OpenQuestion holds

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Registered trials

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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.