• Jae Hyun Kim, Kyoung Sik Nam, Hye Jung Kwon, Youn Jung Choi, Kyoungwon Jung, Sung Eun Kim, Won Moon, Moo In Park, and Seun Ja Park.
• Division of Gastroenterology, Department of Internal Medicine, Kosin University College of Medicine, Busan 602-702, South Korea.
• World J. Gastroenterol. 2017 Sep 14; 23 (34): 6281-6286.

AimTo determine the inter-observer variability for colon polyp morphology and to identify whether education can improve agreement among observers.MethodsFor purposes of the tests, we recorded colonoscopy video clips that included scenes visualizing the polyps. A total of 15 endoscopists and 15 nurses participated in the study. Participants watched 60 video clips of the polyp morphology scenes and then estimated polyp morphology (pre-test). After education for 20 min, participants performed a second test in which the order of 60 video clips was changed (post-test). To determine if the effectiveness of education was sustained, four months later, a third, follow-up test was performed with the same participants.ResultsThe overall Fleiss' kappa value of the inter-observer agreement was 0.510 in the pre-test, 0.618 in the post-test, and 0.580 in the follow-up test. The overall diagnostic accuracy of the estimation for polyp morphology in the pre-, post-, and follow-up tests was 0.662, 0.797, and 0.761, respectively. After education, the inter-observer agreement and diagnostic accuracy of all participants improved. However, after four months, the inter-observer agreement and diagnostic accuracy of expert groups were markedly decreased, and those of beginner and nurse groups remained similar to pre-test levels.ConclusionThe education program used in this study can improve inter-observer agreement and diagnostic accuracy in assessing the morphology of colon polyps; it is especially effective when first learning endoscopy.

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