Clinical Edge

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Interactive online module improved detection of Barrett’s esophagus neoplasia

Key clinical point: An online educational tool for endoscopists helped improve their detection of Barrett’s esophagus–related neoplasia (BORN).

Major finding: Median rates of BORN detection rose by 30% after training (P less than .0001).

Study details: Development and validation of an educational module by three experts and 189 assessors.

Disclosures: The investigators disclosed no external funding sources. They reported having no conflicts of interest.


Bergman JJ et al. Gastroenterology. 2019 Jan 2. doi: 10.1053/j.gastro.2018.12.021.


Endoscopic mucosal resection and ablation strategies offer the potential for minimally invasive, curative treatment for patients with Barrett’s esophagus–associated intramucosal neoplasia. For the gastroenterologist interested in endoscopic prevention and management of esophageal cancer, however, achieving proficiency in performance of these endoscopic techniques represents only part of the requisite preparatory experience. Acquisition of cognitive skills in lesion recognition is a fundamental and underappreciated component to a successful endoscopic treatment paradigm.

This study by Dr. Bergman and colleagues describes development and validation of a high-definition white light endoscopy–based video training module for detection of Barrett’s esophagus–related neoplasia. Intensive effort was invested in design of this educational module, which has explicitly set high stakes by carefully selecting “early, endoscopically curable neoplastic lesion[s]” for inclusion – in other words, the failure of an endoscopist to recognize such a lesion and triage the lesion to timely therapy could have profound consequences should disease progress beyond an endoscopically curable stage.

General endoscopist assessors were grouped into three groups based on level of experience. Following completion of the training module, scores in lesion detection and delineation increased irrespective of level of endoscopist experience.

The module is free, CME-accredited, and available for online use. Any endoscopist who performs Barrett’s screening, surveillance, and therapy should be motivated and incentivized to engage with this important educational tool.

Patrick Yachimski, MD, MPH, AGAF, is associate professor of medicine, director of pancreatobiliary endoscopy, division of gastroenterology, hepatology & nutrition, Vanderbilt University Medical Center, Nashville, Tenn. He has no conflicts.