• Training issues/establishment of competency
Training needs to be available to ensure the effectiveness of any new technology as it becomes used in non-research settings. Quality measures would need to be developed to ensure consistent, high confidence examinations. Gastroenterological societies, such as ASGE, would develop position statements on minimum requirements for both trainees and practicing clinicians.
Important tools for training would include educational materials, both in print and online, image libraries and hands-on workshops. There should be a way for individual practitioners to monitor their own accuracy as a performance quality measure (eg, prediction of neoplasia in lesions using white-light and/or enhanced imaging techniques, similar to detection of colonic adenomas).
• Other issues considered in establishing the thresholds
• Limitations of current methods for surveillance of patients with Barrett’s esophagus
• Low risk of high-grade dysplasia/esophageal adenocarcinoma in patients with nondysplastic Barrett’s esophagus
• Costs of standard endoscopy and biopsy
The PIVI committee (consisting of a committee of ASGE physician experts) in preparing the document, employed evidence-based methodology, using a MEDLINE and PubMed literature search to identify pertinent clinical studies on the topic. The PIVI is provided solely for educational and informational purposes and to support incorporating these endoscopic technologies into clinical practice. It should not be construed as establishing a legal standard of care. To read the full PIVI document, visit ASGE's website here.