Looking towards objective quality evaluation in colonoscopy: Analysis of visual gaze patterns

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Title: Looking towards objective quality evaluation in colonoscopy: Analysis of visual gaze patterns
Authors: Edmondson, MJ
Pucher, PH
Sriskandarajah, K
Hoare, J
Teare, J
Yang, G-Z
Darzi, A
Sodergren, MH
Item Type: Journal Article
Abstract: Background and Aim There are currently limited training and assessment tools available to novice endoscopists. A potential tool for the objective assessment of endoscopist visual search strategy is eye‐tracking technology. The aim of this study is to assess whether eye‐tracking technology can be used to differentiate the visual gaze patterns (VGP) of experienced and novice endoscopists, and to characterize any differences arising between the two groups. Method With the use of portable eye‐tracking glasses, VGP of novice (n = 20) and experienced (n = 14) endoscopists were compared while viewing a colonoscopy withdrawal through the hepatic flexure. Analysis was performed by comparing the central versus peripheral distribution and the horizontal distribution of novice and experienced endoscopist fixations, along with comparison of basic eye‐tracking metrics. Results This study found that experienced endoscopists had a significantly higher percentage of fixations within the periphery of the screen (13.4% vs 23.0%, P = 0.013). Experienced endoscopists also had a significantly greater percentage of fixations on the left side of the screen (18.6% vs 33.5%, P = 0.005) that displayed the poorly visualized “inside bend” of the hepatic flexure. Conclusion This study has detailed specific VGP acquired through expertise, which can potentially explain why adenomas are regularly missed at the hepatic flexure during colonoscopy. These may be useful for the training of novice colonoscopists, and further validation may utilize VGP in the development of an objective proficiency based curriculum to improve the detection of pathology and overall quality in endoscopy.
Issue Date: 26-Feb-2016
Date of Acceptance: 26-Aug-2015
URI: http://hdl.handle.net/10044/1/58768
DOI: https://dx.doi.org/10.1111/jgh.13184
ISSN: 0815-9319
Publisher: WILEY-BLACKWELL
Start Page: 604
End Page: 609
Journal / Book Title: JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY
Volume: 31
Issue: 3
Copyright Statement: © 2015 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd. This is the accepted version of the following article: Edmondson, M. J., Pucher, P. H., Sriskandarajah, K., Hoare, J., Teare, J., Yang, G.‐Z., Darzi, A., and Sodergren, M. H. (2016) Looking towards objective quality evaluation in colonoscopy: Analysis of visual gaze patterns. Journal of Gastroenterology and Hepatology, 31: 604–609. doi: 10.1111/jgh.13184.
Sponsor/Funder: National Institute for Health Research
Funder's Grant Number: NF-SI-0510-10186
Keywords: Science & Technology
Life Sciences & Biomedicine
Gastroenterology & Hepatology
colonoscopy
endoscopy
eye tracking
ADENOMA DETECTION RATE
LAPAROSCOPIC CHOLECYSTECTOMY
STRATEGIES
RATES
Adenoma
Colonic Neoplasms
Colonoscopy
Curriculum
Humans
Professional Competence
Quality Assurance, Health Care
1103 Clinical Sciences
Publication Status: Published
Appears in Collections:Faculty of Engineering
Division of Surgery
Computing
Faculty of Medicine



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