Clin Endosc.  2013 Nov;46(6):633-636.

Learning Curve of Capsule Endoscopy

• Korean Gut Image Study Group
• Lim YJ
• Joo YS
• Jung DY
• Ye BD
• Kim JH
• Cheon JH
• Kim SE
• Do JH
• Jang BI
• Moon JS
• Kim JO
• Chun HJ
• Choi MG

Abstract

BACKGROUND/AIMS
Capsule endoscopy (CE) has become an important tool for the diagnosis of small bowel disease. Although CE does not require the skill of endoscope insertion, the images should be interpreted by a person with experience in assessing images of the gastrointestinal mucosa. This investigation aimed to document the number of cases needed by trainees to gain the necessary experience for CE competency.
METHODS
Fifteen cases were distributed to 12 trainees with no previous experience of CE during their gastroenterology training as clinical fellows. Twelve trainees and an expert were asked to read CE images from one patient each week for 15 weeks. The diagnosis was reported using five categories (no abnormalities detected, small bowel erosion or ulcer, small bowel tumor, Crohn disease, and active small bowel bleeding with no identifiable source). We then examined, using the kappa coefficient, how the degree of mean agreements between the trainees and the expert changed as the training progressed each week.
RESULTS
The agreement rate of CE diagnosis increased as the frequencies of interpretation increased. Most of the mean kappa coefficients were >0.60 and >0.80 after week 9 and 11, respectively.
CONCLUSIONS
Experience with approximately 10 cases of CE is appropriate for trainees to attain CE competency.

Keyword

Capsule endoscopy; Learning curve

MeSH Terms

Capsule Endoscopy*
Crohn Disease
Diagnosis
Endoscopes
Gastroenterology
Hemorrhage
Humans
Learning Curve*
Learning*
Mucous Membrane
Ulcer

Figure

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  Fig. 1 Mean κ values at different span sizes.

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