score/[id]

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CLASSIFICATION
Classification
WASP classification (HP / SSL / adenoma)
Separates hyperplastic polyps, SSL, and adenomas <10 mm by NICE first, then Hazewinkel SSL features. Separate from both NICE and JNET.
Classification overview
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Steps
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Step 1 · NICE · Type 1 vs Type 2
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Step 2 · SSL features · Hazewinkel criteria
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Diagnosis
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Type 1 + <2 SSL features
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Type 1 + ≥2 SSL features
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Type 2 + <2 SSL features
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Type 2 + ≥2 SSL features
Algorithm
Tap a choice to highlight the path and see the next step. The diagnosis appears after every step is chosen.
Polyp <10 mm
NICE
Type 1
SSA/P-like features
<2
Hyperplastic polyp
≥2
SSA/P
Type 2
SSA/P-like features
<2
Adenoma
≥2
SSA/P
Algorithm
Is this NICE Type 1 or Type 2?
Type 2 features: (1) darker than the surrounding mucosa, (2) prominent brown vessels, or (3) an oval, tubular, or branched surface pattern. Any of these → Type 2. None → Type 1.
Diagnosis
Select every item to see the result
Step 1 · NICE
Type 1 vs Type 2
Type 2 features
(1) a darker colour than the surrounding mucosa, (2) prominent brown vessels or (3) an oval, tubular or branched surface pattern
Type 1
NICE type 2 features are not present
Type 2
NICE type 2 features are present
Note: A separate classification from NICE itself. It addresses the limitation that NICE Type 1 does not include SSL.
Step 2 · SSL features
Hazewinkel criteria
Quach 2024, Fig. 4b, Not original, CC BY
Quach 2024, Fig. 4c, Not original, CC BY
Quach 2024, Fig. 4d, Not original, CC BY
Features
(1) a clouded surface, (2) indistinctive borders, (3) irregular shape and (4) dark spots inside the crypts
Threshold
The presence of at least two SSA/P-like features is considered sufficient to diagnose an SSA/P
Type 1 + <2 SSL features
Pathway
NICE type 1, then fewer than two SSA/P-like features
Diagnosis
Hyperplastic polyp
Type 1 + ≥2 SSL features
Pathway
NICE type 1, then at least two SSA/P-like features
Diagnosis
Sessile serrated adenoma/polyp (SSA/P)
Type 2 + <2 SSL features
Pathway
NICE type 2, then fewer than two SSA/P-like features
Diagnosis
Adenoma
Type 2 + ≥2 SSL features
Pathway
NICE type 2, then at least two SSA/P-like features
Diagnosis
Sessile serrated adenoma/polyp (SSA/P)
IJspeert 2016, Fig. 1, Original
Quach 2024, Fig. 4, Not original, CC BY
Reference
Original article
IJspeert JEG et al. Gut 2016;65:963-970
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Decision support only. Follow current guidelines and local protocols. Classification definitions and terminology follow the original publication language.