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Geffrier C, de Parades V, Abramowitz L, Benfredj P, Bonnaud G, Bord C, Bouchard D, Bouguen G, Devulder F, Didelot JM, Fathallah N, Higuero T, Lesage X, Nouts A, Petit P, Pigot F, Pommaret E, Roumeguere P, Siproudhis L, Staumont G, Zeitoun JD, Marteau P. Online training on how to diagnose anoperineal lesions of Crohn's disease: Do pictures matter? A nationwide randomized study. Clin Res Hepatol Gastroenterol 2019; 43:483-496. [PMID: 30935906 DOI: 10.1016/j.clinre.2018.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 12/03/2018] [Indexed: 02/04/2023]
Abstract
UNLABELLED Any gastroenterologist must be trained to properly diagnose anoperineal lesions in patients with Crohn's disease (APLOC). The aim of this study was to establish whether adding pictures would improve teaching effectiveness of the diagnosis of APLOC to French gastroenterology trainees. METHOD Trainees were asked to answer a first web-based survey consisting of evaluating 12 pictures of APLOC with a closed answer questionnaire. They were then randomized in 2 groups. Group A received an online teaching with typical pictures and APLOC definitions and group B definitions only. Trainees were asked again seven days later to answer a second survey with 12 other pictures of APLOC and 14 experts also answered this survey. Diagnostic scores were expressed in %. The primary endpoint was the comparison of the score of survey 2 between the two groups of trainees. Secondary endpoints were to compare results of survey 2 between trainees of both groups and experts, and assess diagnosis of each lesion. RESULTS Two hundred fourty eight trainees among 465 answered survey 1, and 195 survey 2. The diagnostic score was 71.9% for groups A and B and 74.6% for experts (differences NS). After training diagnosis of ulceration was 72% for group A and 72.9% for group B, fistulae 85.2% versus 85.8%, erythema 44.1% vs. 55.6%, anoperineal scars 67.5% vs. 65.6%, and abscess 100% (differences NS). CONCLUSION There was no difference between the two teaching methods. Further research should be performed aiming at improving teaching material and quotation baremes.
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Affiliation(s)
- C Geffrier
- Department of digestive diseases, CHU de Louis-Mourier, AP-HP, 92700 Colombes, France
| | - V de Parades
- Department of proctology, groupe hospitalier Paris Saint Joseph, institut Léopold-Bellan, Paris, France
| | - L Abramowitz
- Department of proctology and digestive diseases, CHU de Bichat, AP-HP, Paris, France
| | - P Benfredj
- Department of proctology, groupe hospitalier Paris Saint Joseph, institut Léopold-Bellan, Paris, France
| | - G Bonnaud
- Department of digestive diseases, clinique des Cèdres, 31700 Cornebarrieu, France
| | - C Bord
- Department of proctology, clinique Beau Soleil, 34070 Montpellier, France
| | - D Bouchard
- Department of proctology, hôpital Bagatelle, 33401 Talence, France
| | - G Bouguen
- Department of digestive diseases, CHU de Pontchaillou, Rennes, France
| | - F Devulder
- Department of digestive diseases and proctology, polyclinique de Courlancy, 51100 Reims, France
| | - J M Didelot
- Department of proctology, Clinique Clementville, 34070 Montpellier, France
| | - N Fathallah
- Department of proctology, Clinique St Antoine, 06004 Nice, France
| | - T Higuero
- Department of proctology, 59280 Armentieres, France
| | - X Lesage
- Department of proctology, 94120 Fontenay-sous-Bois, France
| | - A Nouts
- Department of proctology, clinique Saint Augustin, 44000 Nantes, France
| | - P Petit
- Department of proctology, clinique Tivoli, 33000 Bordeaux, France
| | - F Pigot
- Department of proctology, clinique St Jean-Languedoc, 31400 Toulouse, France
| | - E Pommaret
- Department of proctology, groupe hospitalier Paris Saint Joseph, institut Léopold-Bellan, Paris, France
| | - P Roumeguere
- Department of proctology, clinique Tivoli, 33000 Bordeaux, France
| | - L Siproudhis
- Department of digestive diseases, CHU de Pontchaillou, Rennes, France
| | - G Staumont
- Department of proctology, clinique St Jean-Languedoc, 31400 Toulouse, France
| | - J D Zeitoun
- Department of digestive diseases and proctology, CHU de Saint Antoine, AP-HP, 75012 Paris, France
| | - P Marteau
- Philippe-Marteau, université Paris Sorbonne, AP-HP, pole digestif, hôpital Saint Antoine 75012 Paris, France.
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Jin WS, Park JH, Lim KI, Tchah H, Ryoo E. Significance of Perianal Lesion in Pediatric Crohn Disease. Pediatr Gastroenterol Hepatol Nutr 2018; 21:184-188. [PMID: 29992118 PMCID: PMC6037796 DOI: 10.5223/pghn.2018.21.3.184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 10/13/2017] [Accepted: 01/17/2018] [Indexed: 12/19/2022] Open
Abstract
PURPOSE Despite the increasing incidence of pediatric Crohn disease (CD) in Korea, data on the characteristics of perianal lesions are scarce. Therefore, we aimed to investigate the characteristics of pediatric CD with accompanying perianal lesions in Korea. METHODS We retrospectively reviewed the medical records of children (age ≤18 years) with confirmed CD at Gachon University Gil Medical Center between 2000 and 2014. Patients were classified into two groups based on the presence or absence of any perianal lesions including skin tags. Additional analysis was performed according to the presence or absence of perianal perforating lesions. RESULTS Among the 69 CD children (mean age, 15.4 years) include in the analysis, 54 (78.3%) had a perianal lesion and 29 (42.0%) had a perianal perforating lesion. The median duration of chief complaints was longer in pediatric CD with any accompanying perianal lesions (5.40 months vs. 1.89 months, p=0.02), while there was no difference between pediatric CD with and without perianal perforating lesions (5.48 months vs. 4.02 months, p=0.18). Perianal symptoms preceded gastrointestinal symptoms in 13 of 29 (44.8%) patients with perianal perforating lesions. CONCLUSIONS CD should be suspected in children with perianal lesions, even in circumstances when gastrointestinal symptoms are absent.
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Affiliation(s)
- Won Seok Jin
- Department of Pediatrics, Gachon University Gil Medical Center, Incheon, Korea
| | - Ji Hyoung Park
- Department of Pediatrics, Gachon University Gil Medical Center, Incheon, Korea
| | - Kyung In Lim
- Department of Pediatrics, Gachon University Gil Medical Center, Incheon, Korea
| | - Hann Tchah
- Department of Pediatrics, Gachon University Gil Medical Center, Incheon, Korea
| | - Eell Ryoo
- Department of Pediatrics, Gachon University Gil Medical Center, Incheon, Korea
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