Trainees’ adenoma detection rate is higher if ≥10 minutes is spent on withdrawal during colonoscopy

Abstract

First-year trainees had a significantly higher ADR if their colonoscopic WT is ≥ 10 min.

Trainee colonoscopists fulfil quality standards for the detection of adenomatous polyps

“…Comparing initial and final ADR values of trainees, no significant differences could be verified [20-22]. In one recent prospective study Gromski surveyed 4 trainee endoscopists for a total of 1210 investigations and calculated an overall ADR of 22% [22]. In accordance with our data no significant difference between ADR values after 50 and 200 consecutive colonoscopies was reported.…”

“…Comparing initial and final ADR values of trainees, no significant differences could be verified [20-22]. In one recent prospective study Gromski surveyed 4 trainee endoscopists for a total of 1210 investigations and calculated an overall ADR of 22% [22].…”

“…The latter requirement has recently been discussed controversially. Though some data seem to confirm the named benchmark number [22] other studies have revealed much higher number of colonoscopies to ensure sufficient quality standards. Sedlack showed that in average 275 colonoscopies were required until an 85% cecal intubation rate was reached [10].…”

Expert opinions and scientific evidence for colonoscopy key performance indicators

“…Other studies suggest similar procedure numbers required to reach competency, with figures between 150 and 600 reported214–222; the data are summarised in a recent review 221. A study from Harvard showed ADR increases between 50 and 100 colonoscopies, with no further rise thereafter 180. Similarly, another study observing 11 fellows demonstrated increases in CIR and a decrease of examination times between years 1 and 3, but no change in ADR between years of training 220.…”

Fellowship Colonoscopy Training and Preparedness for Independent Gastroenterology Practice

“…Similarly, although factors such as participation in an endoscopic quality improvement project, night call and sleep deprivation, withdrawal time, and breaks in training have previously been determined to affect colonoscopy performance, these specific variables were not investigated in this study. [22][23][24][25] Finally, although this study focuses on technical competency in colonoscopy, recently published guidelines for monitoring of fellow competency focus not only on technical, but also cognitive, and integrative competencies such as that proposed by Walsh et al 16 We too, appreciate that the competency of a gastroenterologist to perform high-quality colonoscopy independently is not solely a function of technical skill, but also those stated in recently updated societal guidelines. 13,16,18 To this point, it should be noted that the quality of preprocedural prep instructions and documentation of an appropriate repeat colonoscopy interval postprocedure, 2 quality metrics not included in this study, are also important metrics for independent GI practice.…”