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Learning curve for EUS in gastric cancer T staging by using cumulative sum analysis

 Chan Hyuk Park  ;  Jun Chul Park  ;  Eun Hye Kim  ;  Da Hyun Jung  ;  Hyunsoo Chung  ;  Sung Kwan Shin  ;  Sang Kil Lee  ;  Yong Chan Lee 
 Gastrointestinal Endoscopy, Vol.81(4) : 898-905, 2015 
Journal Title
 Gastrointestinal Endoscopy 
Issue Date
Aged ; Clinical Competence* ; Endosonography* ; Female ; Humans ; Learning Curve* ; Male ; Middle Aged ; Neoplasm Staging* ; Retrospective Studies ; Stomach Neoplasms/diagnostic imaging* ; Stomach Neoplasms/pathology* ; Tumor Burden
BACKGROUND: EUS is an operator-dependent procedure and requires more technical and cognitive skills than a routine endoscopic procedure. The learning curve for the staging of gastric cancer, however, has not been evaluated. OBJECTIVE: To evaluate the threshold number of EUS examinations for gastric cancer T staging. DESIGN: Retrospective study. SETTING: University-affiliated tertiary care hospital in the Republic of Korea. PATIENTS: Four trainees with no previous EUS experience. INTERVENTION: Analyzing performance of EUS trainees in gastric cancer T staging by using cumulative sum (CUSUM) analysis. MAIN OUTCOME MEASUREMENTS: CUSUM plot and a minimal number of procedures for reaching a plateau. RESULTS: A total of 553 initial EUS examinations for treatment-naïve gastric cancers, performed by trainees, were enrolled in the study. The final T stage was determined by experts by using EUS in 332 gastric cancer cases, whereas the T stage of the other 221 lesions was determined by trainees by using EUS. The accuracy of EUS examinations performed by trainees and experts was 72.6% and 84.3%, respectively. The number of EUS examinations required to reach the first plateau in each trainee was 20, 41, 60, and 65. LIMITATIONS: Retrospective study with a relatively small number of trainees. CONCLUSION: The CUSUM scores of all of 4 trainees in the study reached a plateau by the 65th examination.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
김은혜(Kim, Eun Hye) ORCID logo https://orcid.org/0000-0001-6691-6837
박준철(Park, Jun Chul) ORCID logo https://orcid.org/0000-0001-8018-0010
박찬혁(Park, Chan Hyuk)
신성관(Shin, Sung Kwan)
이상길(Lee, Sang Kil) ORCID logo https://orcid.org/0000-0002-0721-0364
이용찬(Lee, Yong Chan)
정다현(Jung, Da Hyun)
정현수(Chung, Hyun Soo)
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