The following is a summary of “Accuracy in Polyp Size Measurement Among Surgeons, Gastroenterologists, Trainees, and Experts: A Prospective Video-Based Study,” published in the March 2024 issue of Gastroenterology by Djinbachian, et al.
Accurate determination of polyp size is crucial for endoscopic decision-making and follow-up planning. However, more needs to be understood about endoscopist accuracy in polyp sizing and the effectiveness of available measurement tools. For a study, researchers sought to compare the accuracy of visual assessment, snare, forceps, and virtual scale endoscope (VSE) in estimating polyp size among a diverse group of endoscopists.
A prospective video-based study was conducted involving 120 polyps measured and recorded using various measurement tools. Polyps were randomized to visual assessment, snare, forceps, or VSE groups. Eleven endoscopists performed video-based measurements using the assigned tools. The primary outcome was relative accuracy in polyp size measurement compared with caliper measurement immediately post-resection.
A total of 1,320 measurements were performed. VSE demonstrated significantly higher relative accuracy compared to forceps (79.3% vs. 71.3%; P < 0.0001), while forceps had significantly higher relative accuracy than visual assessment (71.3% vs. 63.6%; P = 0.0036). No significant difference was observed between visual assessment and snare-based measurements (63.6% vs. 62.8%; P = 0.797). Overall, 21.5% of polyps >5 mm were misclassified as ≤5 mm, and 17.3% of polyps ≥10 mm were misclassified as <10 mm. VSE had the lowest percentage of misclassifications for polyps >5 mm as ≤5 mm (2.6%), polyps ≤5 mm as >5 mm (5.1%), and polyps <10 mm as ≥10 mm (1.7%).
Visual estimation of polyp size is consistently inaccurate across training levels, sex, and specialty. However, size measurement accuracy can be improved with forceps, particularly when utilizing adaptive scale technology such as VSE.
Reference: journals.lww.com/ajg/abstract/2024/03000/accuracy_in_polyp_size_measurement_among_surgeons,.26.aspx