{
  "abstract": "Objective Accurate real-time assessment of cancer risk in large (≥20 mm) non-pedunculated colorectal polyps (LNPCPs) guides endoscopic versus surgical management. We evaluated whether a structured, interactive e-learning intervention improves cancer detection in LNPCPs among general endoscopists.Design/method Early-career gastroenterologists (≤3 years qualified) and trainees in Flanders (Belgium) completed two online assessments of 20 standardised adenomatous LNPCP videos, separated by a 90-minute interactive e-learning session covering overt (demarcated area) and covert (size, granularity, location, Paris) cancer features. Videos were shown in random order at each assessment without histopathology feedback. Diagnostic outcomes (accuracy, sensitivity, specificity) were estimated using mixed-effects logistic models with a random intercept for reader; 95% CIs and two-sided p values are reported.Results 17 participants (13 trainees and four early-career gastroenterologists) completed all assessments (680 total assessments). Following the e-learning intervention, accuracy improved significantly from 50.4% (95% CI 42.6% to 58.2%) to 70.3% (95% CI 63.1% to 76.7%, p<0.001), sensitivity from 69.1% (95% CI 57.2% to 78.9%) to 88.2% (95% CI 78.2% to 94.0%, p=0.008) and specificity from 45.5% (95% CI 37.4% to 53.8%) to 65.6% (95% CI 57.5% to 72.9%, p<0.001). Gains were concentrated among less experienced endoscopists (≤200 colonoscopies ever), with performance rising to that of more experienced peers. Non-confident assessments decreased from 14.1% to 0.9%.Conclusion A single 90-minute structured e-learning intervention significantly enhanced accuracy, sensitivity and specificity of cancer prediction in LNPCPs among general endoscopists, particularly those with limited experience. These findings highlight the potential of online training programmes to optimise endoscopic decision-making, reduce unnecessary surgeries for benign lesions and improve patient outcomes.Trial registration number NCT05699954.",
  "authors": [
    {
      "affiliations": [
        "Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium",
        "Department of Gastroenterology and Hepatology, UZ Brussel, Brussels, Belgium"
      ],
      "name": "Pieter Jan Poortmans"
    },
    {
      "affiliations": [
        "Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium",
        "Department of Gastroenterology and Hepatology, UZ Brussel, Brussels, Belgium"
      ],
      "name": "Lynn K Debels"
    },
    {
      "affiliations": [
        "Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium",
        "Department of Gastroenterology and Hepatology, University Hospital Ghent, Ghent, Belgium"
      ],
      "name": "Maria Eva Argenziano"
    },
    {
      "affiliations": [
        "Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium",
        "Department of Pathology, University Hospital Ghent, Ghent, Belgium"
      ],
      "name": "Anne Hoorens"
    },
    {
      "affiliations": [
        "Department of Gastroenterology and Hepatology, University Hospital Ghent, Ghent, Belgium",
        "Clinic of Gastroenterology, Hepatology and Emergency Digestive Endoscopy, Università Politecnica delle Marche, Ancona, Italy"
      ],
      "name": "Michele Montori"
    },
    {
      "affiliations": [
        "Department of Gastroenterology and Hepatology, University Hospital Ghent, Ghent, Belgium",
        "Gastroenterology Unit, Padua University Hospital, Padua, Italy"
      ],
      "name": "Andrea Sorge"
    },
    {
      "affiliations": [
        "Department of Gastroenterology and Hepatology, UZ Brussel, Brussels, Belgium"
      ],
      "name": "Hendrik Reynaert"
    },
    {
      "affiliations": [
        "Department of Gastroenterology and Hepatology, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, UK",
        "Department of Gastroenterology and Hepatology, Cheltenham General Hospital, Cheltenham, UK"
      ],
      "name": "Roland Valori"
    },
    {
      "affiliations": [
        "Department of Gastroenterology and Hepatology, University Hospital Ghent, Ghent, Belgium",
        "Department of Gastroenterology and Hepatology, AZ Delta vzw, Roeselare, Belgium"
      ],
      "name": "Lobke Desomer"
    },
    {
      "affiliations": [
        "Department of Gastroenterology and Hepatology, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, UK",
        "Department of Gastroenterology and Hepatology, Cheltenham General Hospital, Cheltenham, UK"
      ],
      "name": "John Anderson"
    },
    {
      "affiliations": [
        "Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium",
        "Department of Gastroenterology and Hepatology, University Hospital Ghent, Ghent, Belgium"
      ],
      "name": "David J Tate"
    }
  ],
  "title": "Structured e-learning intervention improves cancer detection in large non-pedunculated colorectal polyps by general endoscopists",
  "uid": "b0779bb5-03d0-55b7-bc42-8d34f23fc2e0"
}