Detection of Endoscopic Resection Scars and Delineation of Recurrence is Trainable (SCAR)

Ghent University Hospital (UZ)

Status: Not yet enrolling

Conditions: Colorectal Polyp; Colorectal Cancer

Treatments: Other: Learning tool

Study type: Interventional

Funder types: Other

Identifiers

NCT06193356

ONZ-2024-0133 - ID16649

Details and patient eligibility

About

Colorectal cancer is prevented by colonoscopy and polypectomy. Failure to recognize the endoscopic resection scar after Endoscopic Mucosal Resection (EMR) risks unrecognized recurrent or residual adenoma (RRA), which may propagate into post-colonoscopy colorectal cancer. Expert series suggest scar recognition and interrogation is well performed with a high negative predictive value of endoscopic imaging vs histopathology. In this study the authors will investigate the performance of endoscopic imaging in detecting RRA at an endoscopic resection scar amongst general endoscopist and the impact of a learning intervention on recognition of RRA.

After consent is given, the participant will open the online survey and fill this in.

First the participant will be asked to create a pseudonym (name+year of birth) and fill in their demographical information (Grade, years in current role, colonoscopy experience, experience of colonic tissue resection, country of employment

The first 15 pictures will be shown prior to a learning intervention. For each picture the same questions will be asked:

• Is this an endoscopic resection scar?
• Based on this image does the scar demonstrate evidence of residual or recurrent adenoma (RRA)?
• What is your level of confidence?
• If the scar shows RRA, how would you treat it? (skip if you feel no RRA).
• If the scar does not show RRA do you feel there is another diagnosis? After the first 15 pictures a video-based learning tool will be shown on detection of RRA.

After the learning tool 15 different pictures will be shown, the same questions will be asked. All responses will be collected by the investigators. Statistical analysis will be performed using visual studio code (Microsoft, Redmond, USA) Images will be selected from the 'Australian Colonic LSL Endoscopic Resection Study' (ACE) database, which is an international multicentre registry of images and videos for retrospective analysis of colonic lesions. Images, videos, procedural information, and histopathological data are stored on a secure online web portal after written informed consent of every participating patient.

Enrollment: 141 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Endoscopists of any experience level

Exclusion criteria

• non consenting adults

Trial design

Primary purpose: Diagnostic

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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141 participants in 2 patient groups

Pre learning tool

No Intervention group

Description:

Assessment of endoscopic images prior to a learning tool about scars and recurrence

post learning tool

Experimental group

Description:

Assessment of endoscopic images after a learning tool about scars and recurrence

Treatment:

Other: Learning tool