Assessment of Blink Impression for Cancer Detection in Colorectal Polyps Among Medical Students and Non-GI Trainees: A Pre-Post Intervention Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 65
- 试验地点
- 1
- 主要终点
- Change in sensitivity for detection of colorectal cancer in polyp images
研究概览
简要总结
This study investigates whether a brief educational intervention using Blink features can improve medical students' and non-GI trainees' ability to detect colorectal cancer in static polyp images. Secondary aims include evaluating changes in specificity, confidence, and interobserver agreement, determining which Blink features support accurate detection, and examining the link between the number of features recognized and diagnostic performance. The study will recruit medical students and non-GI trainees without prior training in polyp morphology or endoscopic image interpretation, who will complete an online pre- and post-intervention image-based survey.
详细描述
Background and Rationale:
Colorectal cancer (CRC) remains a leading cause of cancer-related mortality in Western countries, though it is largely preventable by detecting and removing precursor lesions such as colorectal polyps. While most polyps are small and benign, 1-2% are large (≥20 mm) non-pedunculated colorectal polyps (LNPCPs), which carry a markedly higher risk of invasive cancer (reported rates 6-15%, depending on morphology, histology, and location).
Accurate optical diagnosis of cancer in LNPCPs is critical for guiding treatment strategy-piecemeal endoscopic resection, en bloc resection, or surgery. However, endoscopists often underperform in identifying cancer within these lesions. Studies have reported correct cancer identification rates as low as 20-40%, even among trained endoscopists, contributing to unnecessary surgeries for benign polyps and missed diagnoses in malignant cases.
One contributing factor is the complexity of existing classification systems, which are rarely applied consistently in clinical practice. Simplified tools may improve accuracy and applicability.
The Blink framework, inspired by Malcolm Gladwell's concept of rapid, intuitive decision-making and aligned with Kahneman's System 1 thinking, condenses cancer recognition into six easily observed features of LNPCPs:
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Diagnostic
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Images of large non-pedunculated colorectal polyps (LNPCPs) obtained from patients who have provided informed consent for the anonymous use of polyp images during colonoscopy (EC-2024-200).
- •Medical students and non-GI trainees who have provided written informed consent to participate in the study.
排除标准
- •Participants (students or non-GI trainees) with prior experience in endoscopy or polyp detection, or those who do not provide informed consent.
- •Images deemed to be of insufficient quality by the principal investigator.
- •Patients who do not provide informed consent for image use and data collection.
研究组 & 干预措施
Single Arm: Blink Features Training
Medical students and non-GI trainees complete a baseline assessment of colorectal polyp images, receive a brief 2-minute educational video on Blink features, and then complete a post-intervention assessment.
干预措施: Blink Features Training Video (Behavioral)
结局指标
主要结局
Change in sensitivity for detection of colorectal cancer in polyp images
时间窗: Immediately before and after the educational intervention (within one online survey session, approximately 15-20 minutes).
Sensitivity will be calculated as the proportion of correctly identified cancerous polyps out of all cancerous polyps presented. Comparison will be made between pre-intervention and post-intervention assessments.
次要结局
- Change in specificity for cancer detection(Immediately before and after the educational intervention (single online session, ~15-20 minutes).)
- Change in self-reported diagnostic confidence(Immediately before and after the educational intervention (same session).)
- Change in interobserver agreement (Fleiss' kappa)(Immediately before and after the educational intervention (same session).)
- Correlation between presence of individual Blink features and correct cancer classification(Baseline (pre-intervention) and immediately after the educational intervention (within the same online survey session, ~15-20 minutes).)
- Correlation between number of Blink features identified and diagnostic accuracy(Immediately after the educational intervention (within the same online survey session, ~15-20 minutes).)
研究者
Dhurgham Razooqi
Gastroenterology trainee (Arts specialist in opleiding)
Universitair Ziekenhuis Brussel