Sa1412 Adenoma Detection Rate & Sessile Serrated Adenoma Detection Rate Trends With Increasing Age: a Study Using a Natural Language Processing Computer Program

Autor: Patrick M. Lynch, Alexander A. Dekovich, Sushovan Guha, Selvi Thirumurthi, Mark J. Routbort, Boris Blechacz, Marta L. Davila, Ethan Miller, John R. Stroehlein, Mehnaz A. Shafi, Mala Pande, Jeffrey H. Lee, Manoop S. Bhutani, Brian Weston, Robert S. Bresalier, Gottumukkala S. Raju, Phillip Lum, Lopa Mishra, William A. Ross, Asif Rashid, Gladis Shuttlesworth, Rebecca Slack
Rok vydání: 2014
Předmět:
Zdroj: Gastrointestinal Endoscopy. 79:AB203
ISSN: 0016-5107
DOI: 10.1016/j.gie.2014.05.031
Popis: Sa1412 Adenoma Detection Rate & Sessile Serrated Adenoma Detection Rate Trends With Increasing Age: a Study Using a Natural Language Processing Computer Program Selvi Thirumurthi*, William A. Ross, Phillip Lum, Ethan Miller, Brian R. Weston, Mala Pande, Patrick M. Lynch, Mehnaz A. Shafi, Manoop S. Bhutani, Alexander A. Dekovich, Boris Blechacz, Jeffrey H. Lee, Marta L. Davila, Robert S. Bresalier, Rebecca S. Slack, Sushovan Guha, Asif Rashid, Mark Routbort, Gladis Shuttlesworth, Lopa Mishra, John R. Stroehlein, Gottumukkala S. Raju Gastroenterology, Hepatology & Nutrition, University of Texas MD Anderson Cancer Center, Houston, TX; Department of Pathology, University of Texas MD Anderson Cancer Center, Houston, TX; Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX; Department of Internal Medicine, Division of Gastroenterology, University of Texas Houston Health Science Center, Houston, TX Background/Aims: Adenoma detection rate (ADR) is a quality metric used by gastroenterologists to evaluate their performance in colonoscopy and polyp detection. There is a trend toward higher ADR and advanced adenoma detection in both men and women with increasing age over 50. Another emerging quality indicator is sessile serrated adenoma detection rate (SDR). However, little is known about the differences in SDR between genders and trends with increasing patient age. We aim to describe trends in ADR, SDR, advanced adenomas and multiple adenomas for average risk patients over age 50 undergoing their first screening colonoscopy using a natural language processing (NLP) computer program. Methods: Three computer programs were developed for data extraction, processing and presentation using NLP (figure 1). Data was extracted from chart notes, endoscopy and pathology databases. NLP was used to link a colonoscopy with its corresponding pathology record, search for prior exams and pathology reports and review chart notes to confirm an indication of screening. This process has been validated at our institution and is submitted for review in a separate abstract. ADR, SDR and rates of advanced adenomas (O 1 cm, villous features) and of multiple adenomas (O3) were obtained for all study patients from 2009 to 2013. We calculated these metrics by patient age group (60-70 andO70) using the age group!60 as a reference point. We also report adenoma burden (# of adenomas/patient with a positive exam) and SSA burden. Results: A total of 3212 colonoscopies were performed during the study period (Table 1). While both ADR and SDR increased with age, only ADR trends were statistically significant among both men and women. ADR for those O age 70 was 3 times higher among women and 2 times higher among men compared to those! age 60. Among women, the rate of advanced adenomas and multiple adenomas increased with increasing age. WomenO age 70 were at nearly 5 times greater risk for advanced polyps and at nearly 6 times greater risk for having O 3 polyps compared to women! age 60. Conclusions: Our study reports a higher rate of ADR and SDR among male and female patients than has been previously reported. We find that ADR increases over each decade of life for men and women O age 60 and female ADR approaches male ADR with age. SDRs did not differ significantly among different age groups suggesting a different biology. Advanced adenoma detection rates were significantly higher in older female patients. All patientsO age 60 had a higher likelihood of having multiple adenomas than patients! age 60. Although further study is required, these findings suggest the importance of performing screening colonoscopy in older patients and female patients. ADR, SDR and Advanced Adenoma Detection Rate and Multiple Adenoma Detection Rates by Age and Gender
Databáze: OpenAIRE
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