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  ‡   ‡
 1   Department of Gastroenterology, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
 2   Department of Gastroenterology and Hepatology, University Hospital of Ghent, Ghent, Belgium
,
Maria Eva Argenziano‡   ‡
 1   Department of Gastroenterology, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
 2   Department of Gastroenterology and Hepatology, University Hospital of Ghent, Ghent, Belgium
 3   Clinic of Gastroenterology, Hepatology and Emergency Digestive Endoscopy, Università Politecnica delle Marche, Ancona, Italy
,
Alexander C. De Crem
 1   Department of Gastroenterology, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
 2   Department of Gastroenterology and Hepatology, University Hospital of Ghent, Ghent, Belgium
,
Lobke Desomer
 9   Department of Gastroenterology and Hepatology, AZ Delta vzw, Roeselare, Belgium
,
John Anderson 
 4   Department of Gastroenterology, Cheltenham General Hospital, Cheltenham, United Kingdom
,
Pradeep Bhandari
 5   Endoscopy Department, Department of Gastroenterology, Portsmouth Hospitals University NHS Trust, Portsmouth, UK
,
Ivo Boškoski 
 6   Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
,
Marek Bugajski
 7   Department of Gastroenterological Oncology, The Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland
,
Michael J. Bourke
 8   Department of Gastroenterology, Westmead Hospital, Sydney Australia
,
Lynn Debels 
 1   Department of Gastroenterology, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
 2   Department of Gastroenterology and Hepatology, University Hospital of Ghent, Ghent, Belgium
,
Steven J. Heitman 
10   Division of Gastroenterology and Hepatology, Department of Medicine and Community Health Sciences, University of Calgary, Cumming School of Medicine, Calgary, Canada
,
Hiroshi Kashida
11   Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
,
Ralph R.T. Lee
 2   Department of Gastroenterology and Hepatology, University Hospital of Ghent, Ghent, Belgium
,
Ivan Lyutakov 
13   Department of Gastroenterology, University Hospital Tsaritsa Yoanna-ISUL, Sofia, Bulgaria
14   Department of Gastroenterology, Medical University-Sofia, Sofia, Bulgaria
,
Liseth Rivero-Sánchez 
15   Department of Gastroenterology, Hospital Clínic de Barcelona, Barcelona, Spain
16   Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
,
Christophe Schoonjans
17   Department of Gastroenterology, AZ Sint-Jan Brugge-Oostende AV, Bruge, Belgium
,
Siwan Thomas-Gibson
18   Wolfson Unit for Endoscopy, St. Mark’s Hospital, London, UK
,
Henrik Thorlacius
19   Clinical Sciences and Surgery, Skåne University Hospital, Lund University, Malmö, Sweden
,
Lorenzo Fuccio 
20   Department of Medical Sciences and Surgery, University of Bologna, Bologna, Italy
,
Tony C. Tham 
21   Division of Gastroenterology, Ulster Hospital, Belfast, Northern Ireland
,
Raf Bisschops 
22   Department of Gastroenterology, University Hospitals Leuven, Leuven, Belgium
,
David J. Tate
 1   Department of Gastroenterology, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
 2   Department of Gastroenterology and Hepatology, University Hospital of Ghent, Ghent, Belgium
› Author AffiliationsTrial Registration: ClinicalTrials.gov Registration number (trial ID): NCT05877456 Type of study: Prospective observational study
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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.

‡ Joint first authors


Supplementary Material



Publication History

Article published online:
14 March 2025

© 2025. European Society of Gastrointestinal Endoscopy. All rights reserved.

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

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