Endoscopy Unit Level Interventions to Improve Adenoma Detection Rate: A Systematic Review and Meta-Analysis

Arora, Anshul; McDonald, Cassandra; Guizzetti, Leonardo; Iansavichene, Alla; Brahmania, Mayur; Khan, Rishad; Wilson, Aze; Jairath, Vipul; Sey, Michael

doi:10.1016/j.cgh.2023.03.049

Cited by 4 publications

(2 citation statements)

References 60 publications

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“…Regardless of the requirement by CMS, all gastroenterologists must monitor the quality of colonoscopies using a metric. The utilization of report cards and having an extra observer during colonoscopy to detect polyps have been linked to enhanced ADRs and are recommended for potential adoption in endoscopy centers [ 54 ].…”

Section: Discussionmentioning

confidence: 99%

Overall Polyp Detection Rate as a Surrogate Measure for Screening Efficacy Independent of Histopathology: Evidence from National Endoscopy Database

Aloysius,

Goyal,

Nikumbh

et al. 2024

Life

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Adenoma detection rate (ADR) is challenging to measure, given its dependency on pathology reporting. Polyp detection rate (PDR) (percentage of screening colonoscopies detecting a polyp) is a proposed alternative to overcome this issue. Overall PDR from all colonoscopies is a relatively novel concept, with no large-scale studies comparing overall PDR with screening-only PDR. The aim of the study was to compare PDR from screening, surveillance, and diagnostic indications with overall PDR and evaluate any correlation between individual endoscopist PDR by indication to determine if overall PDR can be a valuable surrogate for screening PDR. Our study analyzed a prospectively collected national endoscopy database maintained by the National Institute of Health from 2009 to 2014. Out of 354,505 colonoscopies performed between 2009–2014, 298,920 (n = 110,794 average-risk screening, n = 83,556 average-risk surveillance, n = 104,770 diagnostic) met inclusion criteria. The median screening PDR was 25.45 (IQR 13.15–39.60), comparable with the median overall PDR of 24.01 (IQR 11.46–35.86, p = 0.21). Median surveillance PDR was higher at 33.73 (IQR 16.92–47.01), and median diagnostic PDR was lower at 19.35 (IQR 9.66–29.17), compared with median overall PDR 24.01 (IQR 11.46–35.86; p < 0.01). The overall PDR showed excellent concordance with screening, surveillance, and diagnostic PDR (r > 0.85, p < 0.01, 2-tailed). The overall PDR is a reliable and pragmatic surrogate for screening PDR and can be measured in real time, irrespective of colonoscopy indication.

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Section: Discussionmentioning

confidence: 99%

Overall Polyp Detection Rate as a Surrogate Measure for Screening Efficacy Independent of Histopathology: Evidence from National Endoscopy Database

Aloysius,

Goyal,

Nikumbh

et al. 2024

Life

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“…We have embraced the importance of high quality colonoscopy over the past 2 decades, and recent data has cemented the relationship between adenoma detection rate (ADR), serrated polyp detection rate, and other quality indicators in preventing post-colonoscopy CRC (5,6). A number of evidence-based interventions are available to optimize colonoscopy quality, including use of accessory devices, as well as report cards and feedback (7,8). Computer aided detection (CADe) of polyps is a promising innovation to improve ADR in both low and high performers by 8%–10% (9).…”

Section: New Guidelines On Crc Screeningmentioning

confidence: 99%