Joseph C Anderson1, Lynn F Butterly2, Julia E Weiss3, Christina M Robinson4. 1. Department of Veterans Affairs Medical Center, White River Junction, Vermont, USA; The Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA. 2. The Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA; Dartmouth Hitchcock Medical Center, Section of Gastroenterology, Lebanon, New Hampshire, USA. 3. Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA. 4. Dartmouth Hitchcock Medical Center, Department of Medicine, Lebanon, New Hampshire, USA.
Abstract
BACKGROUND AND AIMS: Similar to achieving adenoma detection rate (ADR) benchmarks to prevent colorectal cancer (CRC), achieving adequate serrated polyp detection rates (SDRs) may be essential to the prevention of CRC associated with the serrated pathway. Previous studies have been based on data from high-volume endoscopists at single academic centers. Based on a hypothesis that ADR is correlated with SDR, we stratified a large, diverse group of endoscopists (n = 77 practicing at 28 centers) into high performers and low performers, based on ADR, to provide data for corresponding target SDR benchmarks. METHODS: By using colonoscopies in adults aged ≥50 years (4/09-12/14), we stratified endoscopists by high and low ADRs (<15%, 15%-<25%, 25%-<35%, ≥35%) to determine corresponding SDRs by using 2 SDR measures, for screening and surveillance colonoscopies separately: (1) Clinically significant SDR (CSSDR), meaning colonoscopies with any sessile serrated adenoma/polyp (SSA/P), traditional serrated adenoma (TSA), or hyperplastic polyp (HP) >1 cm anywhere in the colon or HP >5 mm in the proximal colon only divided by the total number of screening and surveillance colonoscopies, respectively. (2) Proximal SDR (PSDR) meaning colonoscopies with any serrated polyp (SSA/P, HP, TSA) of any size proximal to the sigmoid colon divided by the total number of screening and surveillance colonoscopies, respectively. RESULTS: A total of 45,996 (29,960 screening) colonoscopies by 77 endoscopists (28 facilities) were included. Moderately strong positive correlation coefficients were observed for screening ADR/CSSDR (P = .69) and ADR/PSDR (P = .79) and a strong positive correlation (P = .82) for CSSDR/PSDR (P < .0001 for all) was observed. For ADR ≥25%, endoscopists' median (interquartile range) screening CSSDR was 6.8% (4.3%-8.6%) and PSDR was 10.8% (8.6%-16.1%). CONCLUSIONS: Derived from ADR, the primary colonoscopy quality indicator, our results suggest potential SDR benchmarks (CSSDR = 7% and PSDR = 11%) that may guide adequate serrated polyp detection. Because CSSDR and PSDR are strongly correlated, endoscopists could use the simpler PSDR calculation to assess quality. Published by Elsevier Inc.
BACKGROUND AND AIMS: Similar to achieving adenoma detection rate (ADR) benchmarks to prevent colorectal cancer (CRC), achieving adequate serrated polyp detection rates (SDRs) may be essential to the prevention of CRC associated with the serrated pathway. Previous studies have been based on data from high-volume endoscopists at single academic centers. Based on a hypothesis that ADR is correlated with SDR, we stratified a large, diverse group of endoscopists (n = 77 practicing at 28 centers) into high performers and low performers, based on ADR, to provide data for corresponding target SDR benchmarks. METHODS: By using colonoscopies in adults aged ≥50 years (4/09-12/14), we stratified endoscopists by high and low ADRs (<15%, 15%-<25%, 25%-<35%, ≥35%) to determine corresponding SDRs by using 2 SDR measures, for screening and surveillance colonoscopies separately: (1) Clinically significant SDR (CSSDR), meaning colonoscopies with any sessile serrated adenoma/polyp (SSA/P), traditional serrated adenoma (TSA), or hyperplastic polyp (HP) >1 cm anywhere in the colon or HP >5 mm in the proximal colon only divided by the total number of screening and surveillance colonoscopies, respectively. (2) Proximal SDR (PSDR) meaning colonoscopies with any serrated polyp (SSA/P, HP, TSA) of any size proximal to the sigmoid colon divided by the total number of screening and surveillance colonoscopies, respectively. RESULTS: A total of 45,996 (29,960 screening) colonoscopies by 77 endoscopists (28 facilities) were included. Moderately strong positive correlation coefficients were observed for screening ADR/CSSDR (P = .69) and ADR/PSDR (P = .79) and a strong positive correlation (P = .82) for CSSDR/PSDR (P < .0001 for all) was observed. For ADR ≥25%, endoscopists' median (interquartile range) screening CSSDR was 6.8% (4.3%-8.6%) and PSDR was 10.8% (8.6%-16.1%). CONCLUSIONS: Derived from ADR, the primary colonoscopy quality indicator, our results suggest potential SDR benchmarks (CSSDR = 7% and PSDR = 11%) that may guide adequate serrated polyp detection. Because CSSDR and PSDR are strongly correlated, endoscopists could use the simpler PSDR calculation to assess quality. Published by Elsevier Inc.
Authors: David A Lieberman; Douglas K Rex; Sidney J Winawer; Francis M Giardiello; David A Johnson; Theodore R Levin Journal: Gastroenterology Date: 2012-07-03 Impact factor: 22.682
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: Joep E G IJspeert; Sascha C van Doorn; Ymkje M van der Brug; Barbara A J Bastiaansen; Paul Fockens; Evelien Dekker Journal: Gastrointest Endosc Date: 2015-04-29 Impact factor: 9.427
Authors: Douglas K Rex; Dennis J Ahnen; John A Baron; Kenneth P Batts; Carol A Burke; Randall W Burt; John R Goldblum; José G Guillem; Charles J Kahi; Matthew F Kalady; Michael J O'Brien; Robert D Odze; Shuji Ogino; Susan Parry; Dale C Snover; Emina Emilia Torlakovic; Paul E Wise; Joanne Young; James Church Journal: Am J Gastroenterol Date: 2012-06-19 Impact factor: 10.864
Authors: Charles J Kahi; David G Hewett; Dustin Lee Norton; George J Eckert; Douglas K Rex Journal: Clin Gastroenterol Hepatol Date: 2010-10-01 Impact factor: 11.382
Authors: Joseph C Anderson; Lynn F Butterly; Martha Goodrich; Christina M Robinson; Julia E Weiss Journal: Clin Gastroenterol Hepatol Date: 2013-05-06 Impact factor: 11.382
Authors: Hassan Siddiki; Sreya Ravi; Mohanad T Al-Qaisi; Ayman R Fath; Francisco Ramirez; Michael D Crowell; Rahul Pannala; Douglas O Faigel; Suryakanth R Gurudu Journal: Dig Dis Sci Date: 2018-05-07 Impact factor: 3.199
Authors: Joseph C Anderson; Lynn F Butterly; Christina M Robinson; Julia E Weiss; Christopher Amos; Amitabh Srivastava Journal: Gastroenterology Date: 2017-09-18 Impact factor: 22.682
Authors: Jennifer K Maratt; Joseph Dickens; Philip S Schoenfeld; Grace H Elta; Kenya Jackson; Daniel Rizk; Christine Erickson; Stacy B Menees Journal: Dig Dis Sci Date: 2017-10-17 Impact factor: 3.199