Evidence map›Paper›PMID 37473969›Full record

Trial reportGastrointestinal endoscopy2023

Structured training program on confocal laser endomicroscopy for pancreatic cystic lesions: a multicenter prospective study among early-career endosonographers (with video).

Jorge D Machicado, Bertrand Napoleon, Venkata Akshintala, Ahmad Najdat Bazarbashi, Mohammad Bilal, Juan E Corral, Mohannad Dugum, Samuel Han, Farah S Hussain, Alyson M Johnson and 16 more

Abstract readMulticenter StudyRandomized Controlled TrialVideo-Audio Media
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Gastrointestinal endoscopy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing 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

6 citing papers in PubMed.

  1. Review
  2. Article
  3. Review
  4. Article
  5. Article
  6. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

26 authors.

Jorge D MachicadoDivision of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan, USA.
Bertrand NapoleonGastroenterology Department, Hopital Privé Jean Mermoz, Ramsay Generale de Sante, Lyon, France.
Venkata AkshintalaDivision of Gastroenterology and Hepatology, Johns Hopkins Medicine, Baltimore, Maryland, USA.
Ahmad Najdat BazarbashiDivision of Gastroenterology, Washington University, St Louis, Missouri, USA.
Mohammad BilalDivision of Gastroenterology, Hepatology, and Nutrition, University of Minnesota, Minneapolis, Minnesota, USA.
Juan E CorralDivision of Gastroenterology and Hepatology, Presbyterian Hospital, Albuquerque, New Mexico, USA.
Mohannad DugumGastro Health, Birmingham, Alabama, USA.
Samuel HanDivision of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
Farah S HussainRMG Gastroenterology, Raleigh, North Carolina, USA.
Alyson M JohnsonDivision of Gastroenterology, Duke University, Durham, North Carolina, USA.
Manol JovaniDivision of Gastroenterology, Maimonides Medical Center, SUNY Downstate University, Brooklyn, New York, USA.
Jennifer M KolbDivision of Digestive Diseases, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA.
Paul LeonorDivision of Gastroenterology and Hepatology, Loma Linda University, Loma Linda, California, USA.
Peter J LeeDivision of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
Ramzi MulkiBasil I. Hirschowitz Endoscopic Center of Excellence, Division of Gastroenterology & Hepatology, Department of Internal Medicine, The University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, USA.
Hamza ShahDivision of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
Harkirat SinghDivision of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Sergio A Sánchez-LunaBasil I. Hirschowitz Endoscopic Center of Excellence, Division of Gastroenterology & Hepatology, Department of Internal Medicine, The University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, USA.
Shawn L ShahDivision of Digestive and Liver Diseases, Veterans Affairs North Texas Health Care System, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Anand SinglaDivision of Gastroenterology, University of Washington, Seattle, Washington, USA.
Eric J VargasDivision of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.
Thomas TiellemanDivision of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Melica NikahdDepartment of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, Ohio, USA.
Megan FryDivision of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
Stacey CulpDepartment of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, Ohio, USA.
Somashekar G KrishnaDivision of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.

Funding

Endoscopic Ultrasound-guided In Vivo Confocal Laser Endomicroscopy as an Imaging Biomarker for the Accurate Risk Stratification of Intraductal Papillary Mucinous NeoplasmsR01CA279965 · NCI · OHIO STATE UNIVERSITY · PI Somashekar G. Krishna · 2023 to 2026
$1.7M
NCI NIH HHS R01 CA279965
6 · The paper itself

Abstract

BACKGROUND AND

aimsData on how to teach endosonographers needle-based confocal laser endomicroscopy (nCLE)-guided histologic diagnosis of pancreatic cystic lesions (PCLs) are limited. Hence, we developed and tested a structured educational program to train early-career endosonographers in nCLE-guided diagnosis of PCLs.

methodsTwenty-one early-career nCLE-naïve endosonographers watched a teaching module outlining nCLE criteria for diagnosing PCLs. Participants then reviewed 80 high-yield nCLE videos, recorded diagnoses, and received expert feedback (phase 1). Observers were then randomized to a refresher feedback session or self-learning at 4 weeks. Eight weeks after training, participants independently assessed the same 80 nCLE videos without feedback and provided histologic predictions (phase 2). Diagnostic performance of nCLE to differentiate mucinous versus nonmucinous PCLs and to diagnose specific subtypes were analyzed using histopathology as the criterion standard. Learning curves were determined using cumulative sum analysis.

resultsAccuracy and diagnostic confidence for differentiating mucinous versus nonmucinous PCLs improved as endosonographers progressed through nCLE videos in phase 1 (P < .001). Similar trends were observed with the diagnosis of PCL subtypes. Most participants achieved competency interpreting nCLE, requiring a median of 38 assessments (range, 9-67). During phase 2, participants independently differentiated PCLs with high accuracy (89%), high confidence (83%), and substantial interobserver agreement (κ = .63). Accuracy for nCLE-guided PCL subtype diagnoses ranged from 82% to 96%. The learned nCLE skills did not deteriorate at 8 weeks and were not impacted by a refresher session.

conclusionsWe developed a practical, effective, and durable educational intervention to train early-career endosonographers in nCLE-guided diagnosis of PCLs.

Indexed as

Endoscopic Ultrasound-Guided Fine Needle AspirationPancreatic CystHumansLasersMicroscopy, ConfocalProspective Studies

Identifiers

PMID37473969
PMCPMC10771632

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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.