The Secondary Quality Indicator to Improve Prediction of Adenoma Miss Rate Apart from Adenoma Detection Rate

Aniwan, Satimai; Orkoonsawat, Piyachai; Viriyautsahakul, Vichai; Angsuwatcharakon, Phonthep; Pittayanon, Rapat; Wisedopas, Naruemon; Sumdin, Sakolkun; Ponuthai, Yuwadee; Wiangngoen, Sumitra; Kullavanijaya, Pinit; Rerknimitr, Rungsun

doi:10.1038/ajg.2015.440

Cited by 73 publications

(88 citation statements)

References 36 publications

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“…14,15 MAP+ has also been reported to be inversely correlated with adenoma miss rate. 16 These adenoma metrics were valuable targets for colonoscopy quality intervention, and the impact of insertion polypectomy on these secondary quality indicators has not been reported in previous studies. In our study, we found that there was no statistically significant difference of overall ADR and these secondary quality indicators between the two study groups.…”

Section: Discussionmentioning

confidence: 91%

“…MAP, MAP+, and ADR‐Plus have been suggested to supplement the ADR in assessing and comparing the ability of endoscopists in detecting multiple adenomas . MAP+ has also been reported to be inversely correlated with adenoma miss rate . These adenoma metrics were valuable targets for colonoscopy quality intervention, and the impact of insertion polypectomy on these secondary quality indicators has not been reported in previous studies.…”

Section: Discussionmentioning

confidence: 99%

“…14 Other secondary quality measures have been suggested to supplement the ADR and include the mean adenoma per procedure (MAP), the mean adenoma per positive procedure (MAP+), the mean additional adenomas detected beyond the first adenoma per positive procedure (ADR-Plus), and the proximal hyperplastic polyp detection rate (PHP-DR). [14][15][16][17][18] The impact of the inspection and polypectomy during the insertion phase of colonoscopy upon these secondary quality indicators is not known.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of polyp detection during both insertion and withdrawal versus only withdrawal of colonoscopy: A prospective randomized trial

Cheng

Kuo

Liu

et al. 2019

J of Gastro and Hepatol

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Background and Aims Polyps seen and not removed during colonoscope insertion are sometimes unable to be found during withdrawal. We aimed to evaluate whether additional inspection and polypectomy during insertion increases adenoma detection rate (ADR) compared with inspection and polypectomy entirely during withdrawal. Methods A total of 421 patients aged ≥ 45 years and undergoing colonoscopy were prospectively randomized to receive inspection and polypectomy during both insertion and withdrawal (study group) or inspection and polypectomy entirely during withdrawal (control group). The primary outcome was the ADR. Secondary outcomes included other adenoma‐related parameters and procedure‐related measures. Results Baseline demographics, procedure indications, preparation quality, total procedure time, sedative doses, colonoscopy difficulty, and patient discomfort were similar between the groups. The insertion time was significantly longer in the study group (11.1 ± 4.8 vs 6.2 ± 4.7 min, P < 0.0001). The withdrawal time was significantly longer in the control group (29.2 ± 9.8 vs 23.1 ± 7.9 min, P < 0.0001). There was no significant difference in the ADR (63.5% [study group] vs 68.1% [control group]), the mean adenoma per procedure (1.6 ± 2.0 vs 1.9 ± 2.4), or the mean adenoma per positive procedure (2.5 ± 2.0 vs 2.7 ± 2.5) between groups. The proximal colon ADR was significantly higher in the control group compared with the study group (56.2% vs 46.0%, P = 0.041). Conclusions Additional inspection and polypectomy during colonoscope insertion did not improve ADR compared with inspection and polypectomy entirely during withdrawal. These results do not support an additional role for routine inspection during insertion (clinical trial registration number: NCT03444090).

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of polyp detection during both insertion and withdrawal versus only withdrawal of colonoscopy: A prospective randomized trial

Cheng

Kuo

Liu

et al. 2019

J of Gastro and Hepatol

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“…Modified ADR metrics, such as APP (adenoma per positive participant), ADR-plus, polypectomy rate, proximal ADR, AADR (advanced adenoma detection rate), or SSADR (sessile serrated adenoma/polyp detection rate), are now being explored. [64][65][66][67][68][69] It is also important to know that the ADR in a FIT-based screening program is expected to be higher than that for colonoscopy-based screening. 70 LGI consensus statement by ANBI 2 G 233…”

Section: Statement 3-1: Image-enhanced Endoscopy (Iee) Can Improve Pomentioning

confidence: 99%

Standards of diagnostic colonoscopy for early‐stage neoplasia: Recommendations by an Asian private group

Sano¹,

Chiu

et al. 2019

Digestive Endoscopy

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Background and AimIn recent years, the incidence of colorectal cancer has been increasing, and it is now becoming the major cause of cancer death in Asian countries. The aim of the present study was to develop Asian expert‐based consensus to standardize the preparation, detection and characterization for the diagnosis of early‐stage colorectal neoplasia.MethodsA professional group was formed by 36 experts of the Asian Novel Bio‐Imaging and Intervention Group (ANBI2G) members. Representatives from 12 Asia–Pacific countries participated in the meeting. The group organized three consensus meetings focusing on diagnostic endoscopy for gastrointestinal neoplasia. The Delphi method was used to develop the consensus statements.ResultsThrough the three consensus meetings with debating, reviewing the literature and regional data, a consensus was reached at third meeting in 2016. The consensus was reached on a total of 10 statements. Summary of statements is as follows: (i) Adequate bowel preparation for high‐quality colonoscopy; (ii) Antispasmodic agents for lesion detection; (iii) Image‐enhanced endoscopy (IEE) for polyp detection; (iv) Adenoma detection rate for quality indicators; (v) Good documentation of colonoscopy findings; (vi) Complication rates; (vii) Cecal intubation rate; (viii) Cap‐assisted colonoscopy (CAC) for polyp detection; (ix) Macroscopic classification using indigocarmine spray for characterization of colorectal lesions; and (x) IEE and/or magnifying endoscopy for prediction of histology.ConclusionThis consensus provides guidance for carrying out endoscopic diagnosis and characterization for early‐stage colorectal neoplasia based on the evidence. This will enhance the quality of endoscopic diagnosis and improve detection of early‐stage colorectal neoplasia.

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“…Tandem studies demonstrate differences in additional adenoma detection and report AMR, whereas parallel studies assess simple detection and report ADR. The relationship between ADR and AMR is unclear; a recent trial from Thailand of 200 patients undergoing back-to-back colonoscopies found no correlation between AMR and ADR among high-ADR providers (r=−0.25; p=0.75) 4. Further studies elucidating the difference between the two research approaches are needed.…”

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confidence: 99%

Response to: ‘Full-spectrum (FUSE) versus standard forward-viewing colonoscopy in an organised colorectal cancer screening programme’ by Hassanet al

Nulsen

Lewis

2016

Gut

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The Secondary Quality Indicator to Improve Prediction of Adenoma Miss Rate Apart from Adenoma Detection Rate

Cited by 73 publications

References 36 publications

Comparison of polyp detection during both insertion and withdrawal versus only withdrawal of colonoscopy: A prospective randomized trial

Comparison of polyp detection during both insertion and withdrawal versus only withdrawal of colonoscopy: A prospective randomized trial

Standards of diagnostic colonoscopy for early‐stage neoplasia: Recommendations by an Asian private group

Response to: ‘Full-spectrum (FUSE) versus standard forward-viewing colonoscopy in an organised colorectal cancer screening programme’ by Hassanet al

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