Bum Su Choung1, Seong Hun Kim2, Kyung Bo Yoo2, Seung Young Seo2, In Hee Kim2, Seung Ok Lee2, Soo Teik Lee2, Sang Wook Kim3. 1. Department of Internal Medicine, Jeonju Hospital, Jeonju, South Korea. 2. Department of Internal Medicine, Research Institute of Clinical Medicine, Chonbuk National University Medical School and Hospital, 634-18 Keumam-dong, Dukjin-gu, Jeonju, Jeonbuk, 561-712, South Korea. 3. Department of Internal Medicine, Research Institute of Clinical Medicine, Chonbuk National University Medical School and Hospital, 634-18 Keumam-dong, Dukjin-gu, Jeonju, Jeonbuk, 561-712, South Korea. clickm@jbnu.ac.kr.
Abstract
BACKGROUND/AIM: The purpose of this research was to evaluate if withdrawal time is a useful index in spite of differences in gastroenterologists' ability and if there are other quality indicators of colonoscopy. METHODS: A total of 665 consecutive, asymptomatic individuals of average risk between 50 and 75 years of age who underwent screening colonoscopies performed by 12 gastroenterologists were included in this study. The endoscopists were classified to either the experienced group (group A, N = 6) or the under-experienced group (group B, N = 6). The endoscopists were unaware that they were being studied during the two-month study period. RESULTS: In group A, adenoma detection rate was 0.56, while in group B it was 0.43 (P = 0.048). The mean withdrawal time ranged widely from 4.2 to 10.3 min per patient with a mean value of 6.83 for group A and 6.54 for group B. There was a significantly positive relationship between the number of adenomas detected and the withdrawal time for group B (r = 0.827, P = 0.005), but not for group A (r = -0.152, P = 0.584). In the case of group A, the ratio of cecal intubation time to withdrawal time (I/E ratio) less than 1 showed significantly correlated adenoma detection rate compared to I/E ratio greater than 1 (r = -0.308, P = 0.036). In the case of group B, mean I/E ratio was 1.7 and all endoscopists' I/E ratios were greater than 1. CONCLUSIONS: For experienced endoscopists, a useful supplementary quality indicator of colonoscopy is to keep intubation/withdrawal time ratio less than 1 and it is necessary for under-experienced endoscopists to try to keep enough withdrawal time.
BACKGROUND/AIM: The purpose of this research was to evaluate if withdrawal time is a useful index in spite of differences in gastroenterologists' ability and if there are other quality indicators of colonoscopy. METHODS: A total of 665 consecutive, asymptomatic individuals of average risk between 50 and 75 years of age who underwent screening colonoscopies performed by 12 gastroenterologists were included in this study. The endoscopists were classified to either the experienced group (group A, N = 6) or the under-experienced group (group B, N = 6). The endoscopists were unaware that they were being studied during the two-month study period. RESULTS: In group A, adenoma detection rate was 0.56, while in group B it was 0.43 (P = 0.048). The mean withdrawal time ranged widely from 4.2 to 10.3 min per patient with a mean value of 6.83 for group A and 6.54 for group B. There was a significantly positive relationship between the number of adenomas detected and the withdrawal time for group B (r = 0.827, P = 0.005), but not for group A (r = -0.152, P = 0.584). In the case of group A, the ratio of cecal intubation time to withdrawal time (I/E ratio) less than 1 showed significantly correlated adenoma detection rate compared to I/E ratio greater than 1 (r = -0.308, P = 0.036). In the case of group B, mean I/E ratio was 1.7 and all endoscopists' I/E ratios were greater than 1. CONCLUSIONS: For experienced endoscopists, a useful supplementary quality indicator of colonoscopy is to keep intubation/withdrawal time ratio less than 1 and it is necessary for under-experienced endoscopists to try to keep enough withdrawal time.
Entities:
Keywords:
Adenoma detection rates; Colonoscopy; Quality assurance; Withdrawal time
Authors: Douglas K Rex; John L Petrini; Todd H Baron; Amitabh Chak; Jonathan Cohen; Stephen E Deal; Brenda Hoffman; Brian C Jacobson; Klaus Mergener; Bret T Petersen; Michael A Safdi; Douglas O Faigel; Irving M Pike Journal: Am J Gastroenterol Date: 2006-04 Impact factor: 10.864
Authors: R Valori; J-F Rey; W S Atkin; M Bretthauer; C Senore; G Hoff; E J Kuipers; L Altenhofen; R Lambert; G Minoli Journal: Endoscopy Date: 2012-09-25 Impact factor: 10.093
Authors: Thomas J W Lee; Matthew D Rutter; Roger G Blanks; Sue M Moss; Andrew F Goddard; Andrew Chilton; Claire Nickerson; Richard J Q McNally; Julietta Patnick; Colin J Rees Journal: Gut Date: 2011-09-22 Impact factor: 23.059
Authors: Elena M Stoffel; D Kim Turgeon; David H Stockwell; Lili Zhao; Daniel P Normolle; Missy K Tuck; Robert S Bresalier; Norman E Marcon; John A Baron; Mack T Ruffin; Dean E Brenner; Sapna Syngal Journal: Cancer Prev Res (Phila) Date: 2008-11
Authors: S J Winawer; A G Zauber; M N Ho; M J O'Brien; L S Gottlieb; S S Sternberg; J D Waye; M Schapiro; J H Bond; J F Panish Journal: N Engl J Med Date: 1993-12-30 Impact factor: 91.245