scholarly journals The Impact of Colonoscopy Quality Control Table on Adenoma Detection Rates

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Bin Deng ◽  
Jiehua Zhi ◽  
Yaosheng Chen ◽  
Lanyu Liang ◽  
Jian Wu ◽  
...  
Keyword(s):  
Success Rate ◽  
Detection Rate ◽  
Intervention Group ◽  
Withdrawal Time ◽  
Detection Rates ◽  
Adenoma Detection ◽  
Significant Difference ◽  
Adenoma Detection Rates ◽  
Colonoscopy Quality ◽  
The Impact

Objective. This study aims to investigate the effects of reporting colonoscopy findings and the regular review of outcomes on adenoma detection rates.Methods. Patients who underwent colonoscopy from August 2013 to February 2014 were selected as the intervention group. The preintervention group included patients who underwent colonoscopy from January 2013 to July 2013, in which the procedure sheet for this group of patients was not accomplished. The primary outcome was adenoma detection rate (ADR), and secondary outcomes included the success rate of intubation and withdrawal time.Results. This study included 2,467 cases: 1,302 cases in the intervention group and 1,165 cases in the preintervention group. There was no significant difference in demographic characteristics between the two groups. In the intervention group, withdrawal time of colonoscopy was longer (P<0.01), and the success rate of intubation (92.5% versus 89.1%,P<0.05) and detection rate of polyps (32.6% versus 27.6%,P<0.05) and adenomas (20.0% versus 16.1%,P<0.05) were higher. Significantly high detection rates for proximal adenomas, flat adenomas, and adenomas with a diameter <5 mm were observed in the intervention group (allP<0.01).Conclusion. The reporting and review of procedure details help to improve quality indicators of colonoscopy.

Endocuff vision-assisted vs. standard polyp resection in the colorectum (the EVASTA study): a prospective randomized study

Endoscopy ◽  
2019 ◽  
Vol 52 (01) ◽  
pp. 45-51 ◽  
Author(s):  
Guido von Figura ◽  
Moritz Hasenöhrl ◽  
Bernhard Haller ◽  
Alexander Poszler ◽  
Jörg Ulrich ◽  
...  
Keyword(s):  
Randomized Study ◽  
Colorectal Polyps ◽  
University Hospital ◽  
Standard Group ◽  
Withdrawal Time ◽  
Detection Rates ◽  
Adenoma Detection ◽  
Adenoma Detection Rates ◽  
Standard Colonoscopy ◽  
The Impact

Abstract Background Cap-assisted colonoscopy is frequently used to facilitate adenoma detection during endoscopy. However, data on how cap assistance influences polyp resection are scarce. We aimed to evaluate the impact of cap assistance with the Endocuff vision device (EVD) on the resection time for colorectal polyps in patients undergoing colonoscopy. Methods A randomized, prospective study was performed in a university hospital in Germany. A total of 250 patients were randomly assigned 1:1 to undergo either colonoscopy with the EVD (EVD arm) or standard colonoscopy without the use of a cap (standard arm). The primary outcome was the average duration of polypectomy. Secondary outcomes included adenoma detection rate, cecal and ileal intubation times, and propofol dosage. Results The use of EVD led to a significant reduction in the median polypectomy time in the EVD vs. standard arm (54 vs. 80 seconds, respectively; P = 0.02). This effect was strongest for polyps ≥ 6 mm. Compared with the standard group, Endocuff assistance also resulted in a shorter cecal intubation time (6 vs. 8 minutes; P = 0.03) and overall colonoscopy time (23 vs. 27 minutes; P = 0.02). In contrast, no difference in withdrawal time was observed. The polyp and adenoma detection rates did not differ significantly between the two groups. Conclusion Endocuff-assisted colonoscopy reduces the duration of polypectomy, which may be due to a more stable scope position during resection. Further studies are needed to investigate whether comparable effects will be seen for other interventions, such as clipping or biopsy sampling.

scholarly journals Comparison of colon adenoma detection rates using cap-assisted and Endocuff-assisted colonoscopy: a randomized controlled trial

2019 ◽  
Vol 07 (12) ◽  
pp. E1585-E1591 ◽  
Author(s):  
Joseph Marsano ◽  
Sheeva Johnson ◽  
Stephanie Yan ◽  
Latifat Alli-Akintade ◽  
Machelle Wilson ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Polyp Size ◽  
Withdrawal Time ◽  
Detection Rates ◽  
Patient Demographics ◽  
Randomized Controlled ◽  
Adenoma Detection ◽  
Significant Difference ◽  
Adenoma Detection Rates

Abstract Objectives and study aim Colonoscopy prevents colorectal cancer by removing adenomatous polyps, but missed adenomas lead to interval cancers. Different devices have been used to increase adenoma detection rates (ADR). Two such devices of interest are the transparent cap (Olympus) and Endocuff (ARC Medical). Our study aimed to compare differences in ADR between Endocuff-assisted colonoscopy (EAC), cap-assisted colonoscopy (CAC) and standard colonoscopy (SC). Patients and methods A sample size of 126 subjects was calculated to determine an effect size of 30 %. Patients undergoing screening or surveillance colonoscopy between March 2016 and January 2017 were randomized to SC, CAC or EAC groups. Three experienced endoscopists performed all colonoscopies. Patient demographics, procedure indication, Boston Bowel Prep Score (BBPS), withdrawal time, polyp size, location, histopathology, were analyzed. Results There was no difference in ADR (52 %, 40 % and 54 %) in the SC, CAC and EAC groups respectively (P = 0.4). Similar findings were also observed for proximal ADR (45 %, 35 %, and 50 %, P = 0.4) and SSA detection rate (16 %, 14 %, and 23 %, P = 0.5). EAC detected higher mean ADR per colonoscopy compared to CAC (1.70 vs 0.76, P = 0.01). However, there was no significant difference in mean ADR per positive colonoscopy (2.08, 1.63, and 2.59, P = 0.21). Conclusion In a randomized controlled trial comparing AC to CAC and SC, neither device conferred additional benefits in ADR among high detectors. When comparing each device, EAC may be better than CAC at detecting more total adenomas.

scholarly journals A120 NO EVIDENCE OF A FRIDAY EFFECT ON COLONOSCOPY QUALITY OUTCOMES

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 101-102
Author(s):  
Z Hindi ◽  
L Guizzetti ◽  
S cocco ◽  
M Brahmania ◽  
A Wilson ◽  
...  
Keyword(s):  
Detection Rate ◽  
Hospital Setting ◽  
Polyp Detection ◽  
Cecal Intubation ◽  
Detection Rates ◽  
Adjusted Risk ◽  
Polyp Detection Rate ◽  
Adenoma Detection ◽  
Significant Difference ◽  
Colonoscopy Quality

Abstract Background Colonoscopy quality may be influenced by operator fatigue. Prior studies have shown lower adenoma detection rates for procedures performed at the end of the day. However, it is unknown if colonoscopy quality is impaired at the end of the work week. Aims We investigated whether colonoscopy quality-related metrics differ at the end of the work week using the South West Ontario Colonoscopy Cohort. Methods Between April 2017 to February 2018, 45,510 consecutive colonoscopies from 20 academic and community hospitals in our health region were captured to form the cohort. In Canada, outpatient endoscopies are generally performed between Monday to Friday, taking Friday, or the last business day, as the last day of the work week compared to the rest of the work week. When a statutory holiday occurred on a Friday, Thursday was designated the last day of the work week. The primary outcome was adenoma detection rate (ADR), and secondary outcomes were sessile serrated polyp detection rate (ssPDR), polyp detection rate (PDR), and failed cecal intubation. Outcomes were presented as unadjusted and adjusted risk ratios derived from modified Poisson regression and adjusting for physician-level clustering, and characteristics of the patient (age, sex, severity), procedure (hospital setting, trainee presence, indication, sedation, bowel preparation quality) and physician (experience and specialty). Results During the observation period, 9,132 colonoscopies were performed on the last day of the work week compared to 36,378 procedures during the rest of the work week. No significant difference was observed for ADR (26.4% vs. 26.6%, p=0.75), ssPDR (4.5% vs. 5.0%, p=0.12), PDR (44.1% vs. 43.1%, p=0.081), or failed cecal intubation (2.8% vs. 2.9%, p=0.51) for colonoscopies performed on the last day of the work week compared to the rest of the week, respectively. After adjusting for potential confounders, there were no significant differences in the ADR (RR 1.01, 95% CI [0.88, 1.15], p=0.94), ssPDR (RR 0.90, 95% CI [0.70, 1.14], p=0.38), PDR (RR 1.00, 95% CI [0.92, 1.09], p=0.94), or failed cecal intubation (RR 0.92, 95% CI [0.72, 1.18], p=0.51) for colonoscopies performed on the last day of the work week compared to the rest of week, respectively. Conclusions Colonoscopy quality metrics, including ADR, ssPDR, PDR, and failed cecal intubation are not significantly different at the end of the week. Funding Agencies None

scholarly journals The Impact of Face Shields on the Quality of Colonoscopy During the COVID-19 Pandemic

2021 ◽  
Author(s):  
Jong Yoon Lee ◽  
Yeo Wool Kang ◽  
Jong Hoon Lee
Keyword(s):  
Quality Indicators ◽  
Detection Rate ◽  
Lesion Detection ◽  
University Hospital ◽  
Detection Rates ◽  
Polyp Detection Rate ◽  
Adenoma Detection ◽  
Colonoscopy Quality ◽  
The Impact

Abstract Background: The coronavirus disease 2019 (COVID-19) has become a global pandemic. Healthcare workers are at a higher risk for exposure to COVID-19 infection than the general population. During the COVID-19 pandemic, endoscopists are recommended to wear personal protective equipment (PPE), including face shields, to prevent COVID-19 transmission. However, to the best of our knowledge, there are no reports on the impact of face shields on the quality of colonoscopy. This study aimed to determine whether the use of PPE, including face shields, affects the quality of colonoscopy during the COVID-19 pandemic.Methods: We retrospectively reviewed the medical records of patients who underwent screening or surveillance colonoscopy performed at Dong-A University Hospital between June 2020 and March 2021 during the COVID-19 pandemic. Endoscopists wore isolation gowns, disposable gloves, and KF94 masks from June 2020 to October 2020. From November 2020, endoscopists additionally wore face shields. Therefore, we compared the colonoscopy quality indicators during the 5 months without the use of face shields and the 5 months with the use of face shields. We calculated the overall adenoma detection rates (ADRs) of the group using face shields and the group not using face shields. Further, the polyp detection rate (PDR), sessile serrated lesion detection rate (SSLDR), advanced neoplasia detection rate (ANDR), polyp per colonoscopy, and adenoma per colonoscopy were calculated for each group.Results: In total, 1,359 patients were included in the study; the face shield and non-face shield groups comprised 679 and 680 patients, respectively. We found no statistically significant differences in the PDR (49.04 vs. 52.50%, p=0.202), ADR (38.59 vs. 38.97%, p=0.884) SSPDR (1.91 vs. 1.32%, p=0.388), and ANDR (3.98 vs. 3.97%, p=0.991) between the groups. In both the experienced endoscopist group and trainee endoscopist group, there was no difference in the colonoscopy quality indicators between the groups of patients examined by endoscopists with and without face shields.Conclusions: The quality indicators of colonoscopy were not affected by face shields during the COVID-19 pandemic.

scholarly journals Effect of Colonoscopy Volume on Quality Indicators

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
David Pace ◽  
Mark Borgaonkar ◽  
Muna Lougheed ◽  
Curtis Marcoux ◽  
Brad Evans ◽  
...  
Keyword(s):  
Case Volume ◽  
Detection Rates ◽  
Adenoma Detection ◽  
Confounding Variables ◽  
Significant Difference ◽  
Adenoma Detection Rates ◽  
Multivariable Regression ◽  
Male Sex ◽  
Colonoscopy Quality

Background. The purpose of this study is to determine if colonoscopy quality is associated with the annual case volume of endoscopists.Methods. A retrospective cohort study was performed on 3235 patients who underwent colonoscopy in the city of St. John’s, NL, between January and June 2012. Data collected included completion of colonoscopy (CCR) and adenoma detection rates (ADR). Endoscopists were divided into quintiles based on annual case volume. To account for potential confounding variables, univariate analyses followed by multivariable logistic regression were used to identify variables independently associated with CCR and ADR.Results. A total of 13 surgeons and 8 gastroenterologists were studied. There was a significant difference in CCR (p< 0.001) and ADR (p< 0.001) based on annual volume. Following multivariable regression, predictors of successful colonoscopy completion included annual colonoscopy volume, lower age, male sex, an indication of screening or surveillance, and a low ASA score. Predictors of adenoma detection included older age, male sex, an indication of screening or surveillance, and gastroenterology specialty.Conclusion. Higher annual case volume is associated with better quality of colonoscopy in terms of completion. However, gastroenterology specialty appears to be a better predictor of ADR than annual case volume.

scholarly journals The analysis of multilevel factors affecting adenoma detection rates for colonoscopies: a large-scale retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Liang Huang ◽  
Yue Hu ◽  
Shan Liu ◽  
Bo Jin ◽  
Bin Lu
Keyword(s):  
Retrospective Study ◽  
Large Scale ◽  
Multivariate Regression Analysis ◽  
Strongly Correlated ◽  
Detection Rates ◽  
Factors Affecting ◽  
Adenoma Detection ◽  
Adenoma Detection Rates ◽  
Colonoscopy Quality ◽  
The Impact

Abstract Background Adenoma detection rate (ADR) is a validated primary quality indicator for colonoscopy procedures. However, there is growing concern over the variability associated with ADR indicators. Currently, the factors that influence ADRs are not well understood. Aims In this large-scale retrospective study, the impact of multilevel factors on the quality of ADR-based colonoscopy was assessed. Methods A total of 10,788 patients, who underwent colonoscopies performed by 21 endoscopists between January 2019 and December 2019, were retrospectively enrolled in this study. Multilevel factors, including patient-, procedure-, and endoscopist-level characteristics were analyzed to determine their relationship with ADR. Results The overall ADR was 20.21% and ranged from 11.4 to 32.8%. Multivariate regression analysis revealed that higher ADRs were strongly correlated with the following multilevel factors: patient age per stage (OR 1.645; 95% CI 1.577–1.717), male gender (OR 1.959; 95% CI 1.772–2.166), sedation (OR 1.402; 95% CI 1.246–1.578), single examiner colonoscopy (OR 1.330; 95% CI 1.194–1.482) and senior level endoscopists (OR 1.609; 95% CI 1.449–1.787). Conclusion The ADR is positively correlated with senior level endoscopists and single examiner colonoscopies in patients under sedation. As such, these procedure- and endoscopist-level characteristics are important considerations to improve the colonoscopy quality.

126 INDIVIDUALIZED FEEDBACK ON COLONOSCOPY SKILLS IMPROVES GROUP COLONOSCOPY QUALITY IN PROVIDERS WITH LOWER ADENOMA DETECTION RATES (ADR)

2019 ◽  
Vol 89 (6) ◽  
pp. AB53
Author(s):  
Anna Duloy ◽  
Mariah Wood ◽  
Mark Benson ◽  
Andrew J. Gawron ◽  
Charles J. Kahi ◽  
...  
Keyword(s):  
Detection Rates ◽  
Adenoma Detection ◽  
Adenoma Detection Rates ◽  
Individualized Feedback ◽  
Colonoscopy Quality

Sizing of Polyp Illustrations Differs by Endoscopists’ Gender and Improves With a Measurement Reference

2019 ◽  
Vol 43 (4) ◽  
pp. 270-273 ◽  
Author(s):  
Nabiha Shamsi ◽  
Aasma Shaukat ◽  
Sofia Halperin-Goldstein ◽  
Joshua Colton
Keyword(s):  
Colorectal Cancer ◽  
Cancer Surveillance ◽  
Community Based ◽  
Polyp Size ◽  
Detection Rates ◽  
Demographic Groups ◽  
Adenoma Detection ◽  
Adenoma Detection Rates ◽  
Colorectal Cancer Surveillance ◽  
The Impact

Colorectal cancer surveillance intervals by colonoscopy are based on the size and number of polyps removed. Evidence suggests endoscopists’ estimation of polyp size is often inaccurate, but the differences by endoscopists’ characteristics have not been reported. This study assesses endoscopists’ accuracy of measuring polyp illustrations, the effect of endoscopists’ characteristics, and the impact of having a measurement reference. Endoscopists in a community-based, gastroenterology practice estimated the size of several illustrations in a booklet. One month later, they estimated the size of illustrations with a provided measurement reference. Accuracy was defined as no difference between estimated and actual value. Endoscopists were accurate in sizing only 15% of the time, with a tendency toward undersizing. Female endoscopists, those with less than 10 years in practice and those with lower adenoma detection rates, were more likely to undersize polyps. Accuracy of measuring the polyp illustrations increased to 50% ( p < .01) with the measurement reference. The improvement in accuracy was seen across endoscopists’ demographic groups. Endoscopists had poor accuracy of measuring polyp illustrations. Almost universally, endoscopists tended to undersize the polyp illustrations. Accuracy improved significantly with the use of a polyp-measuring guide, particularly when considering important surveillance thresholds of 5 and 10 mm.

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