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, SangKil Lee, Yongchan Lee

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)898-905.e1
JournalGastrointestinal Endoscopy
Volume81
Issue number4
DOIs
Publication statusPublished - 2015 Apr 1

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Learning Curve
Neoplasm Staging
Stomach Neoplasms
Retrospective Studies
Republic of Korea
Tertiary Healthcare
Tertiary Care Centers

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

Park, Chan Hyuk ; Park, Jun Chul ; Kim, Eun Hye ; Jung, Da Hyun ; Chung, Hyunsoo ; Shin, Sung Kwan ; Lee, SangKil ; Lee, Yongchan. / Learning curve for EUS in gastric cancer T staging by using cumulative sum analysis. In: Gastrointestinal Endoscopy. 2015 ; Vol. 81, No. 4. pp. 898-905.e1.
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Learning curve for EUS in gastric cancer T staging by using cumulative sum analysis. / Park, Chan Hyuk; Park, Jun Chul; Kim, Eun Hye; Jung, Da Hyun; Chung, Hyunsoo; Shin, Sung Kwan; Lee, SangKil; Lee, Yongchan.

In: Gastrointestinal Endoscopy, Vol. 81, No. 4, 01.04.2015, p. 898-905.e1.

Research output: Contribution to journalArticle

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N2 - 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.

AB - 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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