Observation On The Effect Of Online Training On Pit Pattern Classification Of Primary Digestive Endoscopists In Xinjiang Corps

Object: To analyze the training effect of Pit pattern classification online training for digestive endoscopists in 16 division-level hospitals of Xinjiang Production and Construction Corps,in order to improve the endoscopic diagnosis ability of primary digestive endoscopists in the Corps and provide reference for their future training and learning methods.Methods: This is a multi-center self before and after control study.Eighty-one digestive endoscopists from 16 divisional hospitals in Xinjiang Corps from January 2021 to January 2022 were selected,and 39 physicians with enteroscopy ≥ 3000 cases were divided into expert group,and 42 physicians with enteroscopy < 3000 cases were divided into non-expert group.A total of 343 images of colorectal polypoid lesions were selected from patients who underwent colonoscopy at the First Affiliated Hospital of Shihezi University School of Medicine from January 2019 to January 2021,as well as from endoscopy books,academic conferences and literature,to form an image database.Before and after online Pit pattern classification training for all physicians,40 images were randomly selected from the image database for testing.Before and after training,the test results of physicians’ judgment of Pit pattern classification of colorectal polypoid lesions were compared.Results:1.There were 96 digestive endoscopists in 16 division-level hospitals of Xinjiang Corps,and 15 of them did not fully participate in the training and pre-and post-training tests due to time conflict,dimission,further study and other reasons.Finally,81 physicians were included in this study.Before and after training,the accuracy rates of all physicians,expert group physicians and non-expert group physicians in judging the Pit pattern classification of overall colorectal polypoid lesions were 36.1% vs 75.4%,42.9% vs 78.6%,29.7% vs 72.5%,respectively.Before and after training,the accuracy of all physicians in judging Pit pattern classification of neoplastic and non-neoplastic lesions was 33.1% vs 73.0%,44.9% vs 82.8%,respectively.The accuracy after training was significantly higher than that before training,and the differences were statistically significant(P < 0.001).After training,the accuracy rate of all physicians in judging the Pit pattern classification of colorectal polypoid lesions(I ～ V N type)was higher than that before training,and the differences were statistically significant(P < 0.001).2.The Kappa values of the consistency test between the judgment results and the correct results of Pit pattern classification of colorectal polypoid lesions before and after training by all physicians,expert group physicians and non-expert group physicians were 0.266 vs 0.718,0.345 vs 0.753,0.193 vs 0.685,respectively.The type I and II of benign lesions were combined,and the type ⅢL ～ VN of malignant lesions were combined.The Kappa value of the consistency test between the judgment results of the nature of colorectal polypoid lesions and the correct results before and after the training of all physicians was0.461 vs 0.851.The consistency before training is poor,weak or general,and the consistency after training is improved to good or very good.3.Physicians’ age,gender,education level,title,hospital level,region,years of working in colonoscopy,the number of colonoscopy cases per month,the number of all colonoscopy cases,whether there is NBI magnifying colonoscopy,NBI magnifying colonoscopy use time,the number of NBI magnifying colonoscopy cases per month,the number of all NBI magnifying colonoscopy cases,whether there is staining magnifying colonoscopy,staining magnifying colonoscopy use time,the number of all staining magnifying colonoscopy cases and other factors have no effect on the difference of test scores before and after training.Conclusion: The online training of Pit pattern classification for primary digestive endoscopists in Xinjiang Corps has significantly improved their ability to use the classification to judge the nature of colorectal polypoid lesions,and this way of online training is suitable for general implementation in primary hospitals of the Corps.