Complementary Effect of the Proportion of Overspeed Frames of Withdrawal and Withdrawal Time on Reflecting Colonoscopy Quality: A Retrospective, Observational Study

Constructing quality indicators that reflect the defect of colonoscopy operation for quality audit and feedback is very important. Previously, we have established a real-time withdrawal speed monitoring system to control withdrawal speed below the safe speed. We aimed to explore the relationship between the proportion of overspeed frames (POF) of withdrawal and the adenoma detection rate (ADR) and to conjointly analyze the influence of POF and withdrawal time on ADR to evaluate the feasibility of POF combined with withdrawal time as a quality control indicator. METHODS: The POF was defined as the proportion of frames with instantaneous speed ≥44 in the whole colonoscopy video. First, we developed a system for the POF of withdrawal based on a perceptual hashing algorithm. Next, we retrospectively collected 1,804 colonoscopy videos to explore the relationship between POF and ADR. According to withdrawal time and POF cutoff, we conducted a complementary analysis on the effects of POF and withdrawal time on ADR. RESULTS: There was an inverse correlation between the POF and ADR (Pearson correlation coefficient −0.836). When withdrawal time was >6 minutes, the ADR of the POF ≤10% was significantly higher than that of POF >10% (25.30% vs 16.50%; odds ratio 0.463, 95% confidence interval 0.296–0.724, P < 0.01). When the POF was ≤10%, the ADR of withdrawal time >6 minutes was higher than that of withdrawal time ≤6 minutes (25.30% vs 21.14%; odds ratio 0.877, 95% confidence interval 0.667–1.153, P = 0.35). DISCUSSION: The POF was strongly correlated with ADR. The combined assessment of the POF and withdrawal time has profound significance for colonoscopy quality control.