Validation of the GPAT – the Global Polypectomy Assessment Tool: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

Sander Smeets; Maria Eva Argenziano; Alexander C. De Crem; Lobke Desomer; John Anderson; Pradeep Bhandari; Ivo Boškoski; Marek Bugajski; Michael J. Bourke; Lynn Debels; Steven J. Heitman; Hiroshi Kashida; Ralph R.T. Lee; Ivan Lyutakov; Liseth Rivero-Sánchez; Christophe Schoonjans; Siwan Thomas-Gibson; Henrik Thorlacius; Lorenzo Fuccio; Tony C. Tham; Raf Bisschops; David J. Tate

doi:10.1055/a-2541-4028

Endoscopy, Table of Contents

Endoscopy 2025; 57(05): 555-566
DOI: 10.1055/a-2541-4028

Position Statement

Validation of the GPAT – the Global Polypectomy Assessment Tool: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

Sander Smeets ‡^‡

¹Department of Gastroenterology, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium

²Department of Gastroenterology and Hepatology, University Hospital of Ghent, Ghent, Belgium

,

Maria Eva Argenziano‡^‡

¹Department of Gastroenterology, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium

²Department of Gastroenterology and Hepatology, University Hospital of Ghent, Ghent, Belgium

³Clinic of Gastroenterology, Hepatology and Emergency Digestive Endoscopy, Università Politecnica delle Marche, Ancona, Italy

,

Alexander C. De Crem

¹Department of Gastroenterology, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium

²Department of Gastroenterology and Hepatology, University Hospital of Ghent, Ghent, Belgium

,

Lobke Desomer

⁹Department of Gastroenterology and Hepatology, AZ Delta vzw, Roeselare, Belgium

,

John Anderson

⁴Department of Gastroenterology, Cheltenham General Hospital, Cheltenham, United Kingdom

,

Pradeep Bhandari

⁵Endoscopy Department, Department of Gastroenterology, Portsmouth Hospitals University NHS Trust, Portsmouth, UK

,

Ivo Boškoski

⁶Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy

,

Marek Bugajski

⁷Department of Gastroenterological Oncology, The Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland

,

Michael J. Bourke

⁸Department of Gastroenterology, Westmead Hospital, Sydney Australia

,

Lynn Debels

¹Department of Gastroenterology, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium

²Department of Gastroenterology and Hepatology, University Hospital of Ghent, Ghent, Belgium

,

Steven J. Heitman

¹⁰Division of Gastroenterology and Hepatology, Department of Medicine and Community Health Sciences, University of Calgary, Cumming School of Medicine, Calgary, Canada

,

Hiroshi Kashida

¹¹Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan

,

Ralph R.T. Lee

²Department of Gastroenterology and Hepatology, University Hospital of Ghent, Ghent, Belgium

,

Ivan Lyutakov

¹³Department of Gastroenterology, University Hospital Tsaritsa Yoanna-ISUL, Sofia, Bulgaria

¹⁴Department of Gastroenterology, Medical University-Sofia, Sofia, Bulgaria

,

Liseth Rivero-Sánchez

¹⁵Department of Gastroenterology, Hospital Clínic de Barcelona, Barcelona, Spain

¹⁶Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain

,

Christophe Schoonjans

¹⁷Department of Gastroenterology, AZ Sint-Jan Brugge-Oostende AV, Bruge, Belgium

,

Siwan Thomas-Gibson

¹⁸Wolfson Unit for Endoscopy, St. Mark’s Hospital, London, UK

,

Henrik Thorlacius

¹⁹Clinical Sciences and Surgery, Skåne University Hospital, Lund University, Malmö, Sweden

,

Lorenzo Fuccio

²⁰Department of Medical Sciences and Surgery, University of Bologna, Bologna, Italy

,

Tony C. Tham

²¹Division of Gastroenterology, Ulster Hospital, Belfast, Northern Ireland

,

Raf Bisschops

²²Department of Gastroenterology, University Hospitals Leuven, Leuven, Belgium

,

David J. Tate

¹Department of Gastroenterology, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium

²Department of Gastroenterology and Hepatology, University Hospital of Ghent, Ghent, Belgium

› Author Affiliations

Abstract

Background Colorectal polypectomy is operator dependent, with variable rates of complete resection. The currently available assessment tools do not provide specific competency-based evaluation of provider technique. We aimed to validate the Global Polypectomy Assessment Tool (GPAT), a novel competency assessment tool for colorectal polypectomy.

Methods GPAT was derived from the ESGE Curriculum for Training in endoscopic mucosal resection in the colon. Members of the curriculum taskforce plus three invited trainees and three medical students (collectively: the assessors) anonymously assessed nine endoscopic-view only polypectomy videos. The primary end point was the correlation of the assessors’ GPAT scores with a consensus-derived reference GPAT score per video. Secondary end points were the assessors’ subjective impression versus their GPAT score and interobserver agreement among assessors’ GPAT scores.

Results 171 GPAT assessments by 19 assessors (consultant gastroenterologists [n = 10], trainee gastroenterologists [n = 4], consultant surgeons [n = 2], and medical students [n = 3]) were analyzed. Reference GPAT scores did not differ significantly from those of the assessors (73.1 % [95 %CI 64.6 %–81.6 %] vs. 69.3 % [95 %CI 64.9 %–81.2 %]; P = 0.47). There was moderate IOA in GPAT scores among gastroenterologists (intraclass correlation coefficient [ICC], 0.52 [moderate]) but not among nongastroenterologists (ICC 0.32 [poor]). GPAT correlated with assessors’ subjective impression of polypectomy quality (correlation coefficient 0.98 [95 %CI 0.90–1.00]; P < 0.001). Overall assessors’ qualitative usability scoring of GPAT was positive.

Conclusions GPAT allows standardized scoring of polypectomies, with moderate IOA among gastroenterologists and correlation with subjective impressions of polypectomy quality. GPAT could standardize assessment of trainee polypectomy competency offering structured feedback on performance.

Full Text

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Supplementary Material

Supplementary material