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GIE: Gastrointestinal Endoscopy June issue study highlights
Date:6/29/2009

blished targets for continuous quality improvement. One such target is adenoma detection rates of 25 percent or greater for men and 15 percent or greater for women aged 50 years and older undergoing first-time screening colonoscopy. Another quality target is a mean minimum withdrawal time, currently suggested to be at least six minutes. With these targets in mind, researchers examined data from one of the longest ongoing programs of screening colonoscopy with the objectives of measuring the variation in polyp detection rates (PDRs) among endoscopists and identifying factors that account for the variation.

Researchers performed a retrospective cross-sectional analysis of summary-level data from endoscopists performing screening colonoscopy for the Lilly Colorectal Cancer Prevention Program in Indiana. All procedures were performed on average-risk, asymptomatic adults aged 50 years or older, who underwent first-time screening colonoscopy between September 1995 and June 2001. The study was approved by the institutional review board of Indiana University. The study included twenty-five endoscopists and 2,664 patients (1,108 women and 1,556 men). Summary-level data was analyzed for each endoscopist, including patient mean age, sex profile, mean procedure time, number of colonoscopies performed and the proportions of patients with any-sized polyp, any-sized adenoma, an adenoma one cm or larger in maximum diameter, and multiple (more than one) adenomas. Multiple linear regression analysis (a technique for determining the linear relationship between one dependent variable and two or more independent variables) identified factors that accounted for the variation in PDRs.

The mean procedure time (MPT) was 17.1 minutes. Adenoma detection rates ranged from seven percent to 44 percent and from zero percent to 13 percent for large polyps, which was not statistically significant. For all polyp categories, only one to three high outlier endoscopists (ie, higher th
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Contact: Anne Brownsey
abrownsey@asge.org
630-570-5635
American Society for Gastrointestinal Endoscopy
Source:Eurekalert

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