Fumiaki Ishibashi1,2,3, Keita Fukushima4,5,6, Konomi Kobayashi7,6, Tomohiro Kawakami7, Ryu Tanaka4, Junko Kato4, Ayako Sato4,5, Kenichi Konda4,8, Kazuaki Sugihara7,4,6, Satoshi Baba4,9. 1. Koganei Tsurukame Clinic, Endoscopy Center, 6-14-28-3F, Honcho, Koganei-shi, Tokyo, 184-0004, Japan. ishibashi@tsurukamekai.jp. 2. Shinjuku Tsurukame Clinic, Digestive Disease Center, 2-11-15, Yoyogi, Shibuya-ku, Tokyo, 151-0053, Japan. ishibashi@tsurukamekai.jp. 3. Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan. ishibashi@tsurukamekai.jp. 4. Shinjuku Tsurukame Clinic, Digestive Disease Center, 2-11-15, Yoyogi, Shibuya-ku, Tokyo, 151-0053, Japan. 5. Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan. 6. Mirraza Shinjuku Tsurukame Clinic, 3-36-10, Shinjuku, Shinjuku-ku, Tokyo, 160-0022, Japan. 7. Koganei Tsurukame Clinic, Endoscopy Center, 6-14-28-3F, Honcho, Koganei-shi, Tokyo, 184-0004, Japan. 8. Department of Gastroenterology, Showa University Hospital, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan. 9. Yotsuya Medical Cube, Endoscopy Center, 7-7, Nibancho, Chiyoda-ku, Tokyo, 102-0084, Japan.
Abstract
BACKGROUND AND PURPOSE: Previous reports have suggested that a longer withdrawal time (WT) during colonoscopy led to an improved adenoma detection rate (ADR); however, there are few controlled studies that substantiated monitoring WT as an educational method. We aimed to validate a feedback and monitoring system to improve the ADR in screening colonoscopy in a prospective case-control setting. METHODS: After collecting data in the pre-feedback period (3.5 months), the individual performance and the average ADR and WT values of the facility were provided to 6 endoscopists in the intervention group, while 3 endoscopists were isolated as the control group during the feedback period (2 weeks). The intervention group consisted of two subgroups, the Fast and Slow WT groups, according to the results from the pre-feedback period. The endoscopists in the intervention group were instructed to be aware of their own WT in each examination during the post-feedback period (4 months). The performances of all endoscopists in the post-feedback period were analyzed and compared with those in the pre-feedback period. RESULTS: Among the initial analyses, the correlation analysis and multivariate analysis revealed that WT was an independent predictor for the ADR (P = 0.0101). After providing individual performance feedback and instruction regarding real-time WT monitoring, the WT was significantly prolonged in the Fast WT group (P = 0.0346) but did not change in the Slow WT and control groups. In addition, the ADR of the Fast WT group significantly improved after the intervention (P = 0.024), whereas the ADR of the Slow WT and control groups did not change. CONCLUSION: Providing individual feedback on ADR and WT and monitoring WT helped improve the endoscopists' ADRs.
BACKGROUND AND PURPOSE: Previous reports have suggested that a longer withdrawal time (WT) during colonoscopy led to an improved adenoma detection rate (ADR); however, there are few controlled studies that substantiated monitoring WT as an educational method. We aimed to validate a feedback and monitoring system to improve the ADR in screening colonoscopy in a prospective case-control setting. METHODS: After collecting data in the pre-feedback period (3.5 months), the individual performance and the average ADR and WT values of the facility were provided to 6 endoscopists in the intervention group, while 3 endoscopists were isolated as the control group during the feedback period (2 weeks). The intervention group consisted of two subgroups, the Fast and Slow WT groups, according to the results from the pre-feedback period. The endoscopists in the intervention group were instructed to be aware of their own WT in each examination during the post-feedback period (4 months). The performances of all endoscopists in the post-feedback period were analyzed and compared with those in the pre-feedback period. RESULTS: Among the initial analyses, the correlation analysis and multivariate analysis revealed that WT was an independent predictor for the ADR (P = 0.0101). After providing individual performance feedback and instruction regarding real-time WT monitoring, the WT was significantly prolonged in the Fast WT group (P = 0.0346) but did not change in the Slow WT and control groups. In addition, the ADR of the Fast WT group significantly improved after the intervention (P = 0.024), whereas the ADR of the Slow WT and control groups did not change. CONCLUSION: Providing individual feedback on ADR and WT and monitoring WT helped improve the endoscopists' ADRs.
Entities:
Keywords:
Adenoma detection rate; Colonoscopy; Quality indicator; Screening; Withdrawal time
Authors: Cristiano Spada; Anastasios Koulaouzidis; Cesare Hassan; Pedro Amaro; Anurag Agrawal; Lene Brink; Wolfgang Fischbach; Matthias Hünger; Rodrigo Jover; Urpo Kinnunen; Akiko Ono; Árpád Patai; Silvia Pecere; Lucio Petruzziello; Jürgen F Riemann; Harry Staines; Ann L Stringer; Ervin Toth; Giulio Antonelli; Lorenzo Fuccio Journal: Diagnostics (Basel) Date: 2022-02-15
Authors: Nancy E Aguilar-Olivos; Ricardo Balanzá; Fernando Rojas-Mendoza; Rodrigo Soto-Solis; Mario A Ballesteros-Amozurrutia; Norma González-Uribe; Justo A Fernández-Rivero Journal: Endosc Int Open Date: 2021-05-27