Table 4.
Summary of Studies of Optical Diagnosis Using Narrow-Band Imaging
| First author, year | Setting | Participants, n | NBI experienced participants, n | Training method | Total polyps, n | Diminutive polyps, n | High-confidence diagnosis | Surveillance Predictions, n | Performance | SI agreement |
|---|---|---|---|---|---|---|---|---|---|---|
| Rex,13 2009 | Academic | 1 | 1 | Image library | 451a | 395 | All: 368/451 (81.6%) Dim: 314/395 (79.5%) |
136 | All high confidence: NPV 95% Accuracy 94% |
128/136 (94%) |
| Rastogi,14 2009 | Academic | 1 | 1 | None | 236a | 170 | NA | NA | All polyps: Sensitivity 95% Specificity 88% Accuracy 92% |
NA |
| Ignjatovic,15 2009 | Academic | 4 | 2b | Image library | 363c | 296 | All: 326/363 (89.8%) | 82 | All polyps: NPV 82% Accuracy 93% |
80/82 (98%) |
| Kaltenbach,16 2015 | Academic | 5 | 5 | “Standardized training” | 1309c | 975 | All: 774/1309 (59.1%) Dim: 680/975 (69.7%) |
558 | All high confidence:d NPV 96.4/92 Accuracy 88.5/87 All left colon: NPV 95.3/93.9 Accuracy 88.6/90.2 |
518/558 (92.8%) |
| Paggi,17 2012 | Community | 6 | 6 | Image library with pre/post-test (Rex/Rhagavendra) | 511c | 399 | All: 86.1%e | 286 | Diminutive polyps: Sensitivity 93.9% Specificity 68.0% Accuracy 84.0% Rectosigmoid polyps: Sensitivity 93.7% Specificity 70.2% Accuracy 84.2% |
237/286 (82.9%) |
| Ladabaum,18 2013 | Community | 12 | 0 | Image library with pre/post-test (Rex/ Rhagavendra) | 2596a | 1858 | Dim: 1481/1849 (80.1%) | 1065 | Diminutive polyps: NPV 75.9% Accuracy 78.1% High-confidence diminutive polyps: NPV 78.3% Accuracy 81.1% All rectosigmoid polyps: NPV 87.4% Accuracy 77.4% |
851/1065 (80%) |
| Kuiper,20 2012 | Community | 3 | 3? Previous participation in ex vivo and in vivo NBI studies | Image library | 281c | All: 231/281 (82%) | 54 | All polyps: Sensitivity 77% Specificity 78.8% Accuracy 77.9% |
44/54 (81%) | |
| Vu,19 2015 | Academic + Community | 6 | 4 | Image library, training session led by expert | 606 | 606 | Dim: 580/606 (95.7%)f | 307 | All high-confidence polyps:g NPV 69% Accuracy 81% |
82.1% |
| Patel, 2015 | Academic | 26 | 0 | Video-based training, active feedback, led by expert | 3012 | 3012 | Dim: 2239/3012 (74.3%) | 1403 | All high confidence: NPV 98.3% Accuracy 84.8% High-confidence rectosigmoid: NPV 94.7% Accuracy 88.1% |
91.2% |
NA, not applicable; SI, surveillance interval.
a
Included polyps >10 mm.
b
Experts performed significantly better than nonexperts.
c
Included polyps ≤10 mm.
d
For near focus/standard view.
e
Colonoscopies with low-confidence diagnoses were excluded from analyses.
f
High confidence defined by visual analog scale ≥7.
g
No difference in performance between community and academic participants.