Training mid-career internists to perform high-quality colonoscopy: a pilot training programme to meet increasing demands for colonoscopy
| Autor: | Christian S. Jackson, Richard M. Strong, Nicole Shah-Ghassemzadeh, David Juma |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Colorectal cancer medicine.medical_treatment Colonoscopy Pilot Projects Colonoscopes 03 medical and health sciences 0302 clinical medicine Primary outcome Cancer screening medicine Internal Medicine Intubation Humans 030212 general & internal medicine Pilot training Aged Aged 80 and over Health Services Needs and Demand medicine.diagnostic_test Crc screening business.industry General surgery General Medicine Middle Aged medicine.disease Surgery 030211 gastroenterology & hepatology Education Medical Continuing Female business Colorectal Neoplasms |
| Zdroj: | Postgraduate medical journal. 93(1102) |
| ISSN: | 1469-0756 |
| Popis: | Background Colorectal cancer (CRC) is the second leading cause of cancer deaths in the USA. Despite a recent rise in CRC screening there remains an increasing demand for colonoscopy, yet a limited supply of gastroenterologists who can meet this need. Objective To determine if a mid-career general internist (GIN) could be trained to perform high-quality colonoscopes via an intensive training programme. Design A GIN trained 2–3 days/week, 4–5 hours/day, for 7 months with an experienced gastroenterologist. Their independent performance was then compared with that of a gastroenterology attending (GA), with and without a gastroenterology fellow (GF). Main measures The primary outcome was to compare caecal intubation rates, adenoma detection rates (ADRs), interval CRC rates and complications between the three groups. Key results 989 patients were initially included in the study, and 818 were included in the final analysis. Caecal intubation rates were 95%, 94% and 93% for the GIN, GA+GF and GA, respectively (p=0.31). The overall polyp detection rates were 68%, 39% and 44% among the GIN, GA+GF and GA, respectively (p Conclusions The GIN attained high success rates in all quality measures. Training mid-career GINs to perform high-quality screening colonoscopes, through a standardised curriculum, may be a reasonable approach to address the growing demand for colonoscopists. |
| Databáze: | OpenAIRE |
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