Importance of endoscopist quality metrics for findings at surveillance colonoscopy: The detection-surveillance paradox
| Autor: | Maria Pellise, Agustín Seoane, Luis Bujanda, Angel Lanas, Colonprev study investigators, Alberto Herreros-de-Tejada, Pedro Zapater, Carolina Mangas-Sanjuan, Oscar Murcia, Guillermo Cacho, Rodrigo Jover, Enrique Quintero, JC Marín-Gabriel, María Chaparro, Joaquín Cubiella, Antoni Castells, Servando Fernández-Díez, David Nicolás-Pérez, David Martínez-Ares, Vicent Hernandez |
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| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Adenoma Colorectal cancer adenoma detection rate Colonoscopy Gastroenterology 03 medical and health sciences 0302 clinical medicine colonoscopy Internal medicine Medicine 030212 general & internal medicine medicine.diagnostic_test business.industry Advanced adenomas General surgery Retrospective cohort study Original Articles medicine.disease Colon cancer Oncology surveillance 030211 gastroenterology & hepatology Surveillance colonoscopy Baseline Colonoscopy Detection rate business colonoscopy quality metrics |
| Zdroj: | Repositorio Institucional de la Consejería de Sanidad de la Comunidad de Madrid Consejería de Sanidad de la Comunidad de Madrid |
| Popis: | Guidelines recommend surveillance colonoscopies based exclusively on findings at baseline colonoscopy. This recommendation leads to the paradox that the higher the baseline colonoscopy quality, the more surveillance colonoscopies will be indicated according to current guidelines.The aim of this study was to evaluate the effect on follow-up findings of different quality metrics of the endoscopist performing the baseline colonoscopy.This retrospective cohort study included individuals with advanced adenomas at baseline colonoscopy. Adenoma detection rate (ADR) and adenomas per colonoscopy rate (APCR) were determined for 44 endoscopists. Surveillance colonoscopies were checked after systematic tracking.A total of 574 individuals were diagnosed with advanced adenomas, of whom 270 received a surveillance colonoscopy. Patients whose baseline colonoscopy endoscopist had an ADR lower than the median of 33.8% had significantly higher rates of advanced neoplasia at follow-up (13.1% vs 4.0%;Our results suggest that the risk of identifying advanced adenomas at follow-up is closely related to the quality metrics of the endoscopist who performs the baseline colonoscopy. |
| Databáze: | OpenAIRE |
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