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Association of trainee participation with adenoma and polyp detection rates

AIM: To investigate whether adenoma and polyp detection rates (ADR and PDR, respectively) in screening colonoscopies performed in the presence of fellows differ from those performed by attending physicians alone. METHODS: We performed a retrospective review of all patients who underwent a screening...

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Autores principales: Qayed, Emad, Shea, Lauren, Goebel, Stephan, Bostick, Roberd M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5437386/
https://www.ncbi.nlm.nih.gov/pubmed/28572874
http://dx.doi.org/10.4253/wjge.v9.i5.204
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author Qayed, Emad
Shea, Lauren
Goebel, Stephan
Bostick, Roberd M
author_facet Qayed, Emad
Shea, Lauren
Goebel, Stephan
Bostick, Roberd M
author_sort Qayed, Emad
collection PubMed
description AIM: To investigate whether adenoma and polyp detection rates (ADR and PDR, respectively) in screening colonoscopies performed in the presence of fellows differ from those performed by attending physicians alone. METHODS: We performed a retrospective review of all patients who underwent a screening colonoscopy at Grady Memorial Hospital between July 1, 2009 and June 30, 2015. Patients with a history of colon polyps or cancer and those with poor colon preparation or failed cecal intubation were excluded from the analysis. Associations of fellowship training level with the ADR and PDR relative to attendings alone were assessed using unconditional multivariable logistic regression. Models were adjusted for sex, age, race, and colon preparation quality. RESULTS: A total of 7503 colonoscopies met the inclusion criteria and were included in the analysis. The mean age of the study patients was 58.2 years; 63.1% were women and 88.2% were African American. The ADR was higher in the fellow participation group overall compared to that in the attending group: 34.5% vs 30.7% (P = 0.001), and for third year fellows it was 35.4% vs 30.7% (aOR = 1.23, 95%CI: 1.09-1.39). The higher ADR in the fellow participation group was evident for both the right and left side of the colon. For the PDR the corresponding figures were 44.5% vs 40.1% (P = 0.0003) and 45.7% vs 40.1% (aOR = 1.25, 95%CI: 1.12-1.41). The ADR and PDR increased with increasing fellow training level (P for trend < 0.05). CONCLUSION: There is a stepwise increase in ADR and PDR across the years of gastroenterology training. Fellow participation is associated with higher adenoma and polyp detection.
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spelling pubmed-54373862017-06-01 Association of trainee participation with adenoma and polyp detection rates Qayed, Emad Shea, Lauren Goebel, Stephan Bostick, Roberd M World J Gastrointest Endosc Retrospective Study AIM: To investigate whether adenoma and polyp detection rates (ADR and PDR, respectively) in screening colonoscopies performed in the presence of fellows differ from those performed by attending physicians alone. METHODS: We performed a retrospective review of all patients who underwent a screening colonoscopy at Grady Memorial Hospital between July 1, 2009 and June 30, 2015. Patients with a history of colon polyps or cancer and those with poor colon preparation or failed cecal intubation were excluded from the analysis. Associations of fellowship training level with the ADR and PDR relative to attendings alone were assessed using unconditional multivariable logistic regression. Models were adjusted for sex, age, race, and colon preparation quality. RESULTS: A total of 7503 colonoscopies met the inclusion criteria and were included in the analysis. The mean age of the study patients was 58.2 years; 63.1% were women and 88.2% were African American. The ADR was higher in the fellow participation group overall compared to that in the attending group: 34.5% vs 30.7% (P = 0.001), and for third year fellows it was 35.4% vs 30.7% (aOR = 1.23, 95%CI: 1.09-1.39). The higher ADR in the fellow participation group was evident for both the right and left side of the colon. For the PDR the corresponding figures were 44.5% vs 40.1% (P = 0.0003) and 45.7% vs 40.1% (aOR = 1.25, 95%CI: 1.12-1.41). The ADR and PDR increased with increasing fellow training level (P for trend < 0.05). CONCLUSION: There is a stepwise increase in ADR and PDR across the years of gastroenterology training. Fellow participation is associated with higher adenoma and polyp detection. Baishideng Publishing Group Inc 2017-05-16 2017-05-16 /pmc/articles/PMC5437386/ /pubmed/28572874 http://dx.doi.org/10.4253/wjge.v9.i5.204 Text en ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Retrospective Study
Qayed, Emad
Shea, Lauren
Goebel, Stephan
Bostick, Roberd M
Association of trainee participation with adenoma and polyp detection rates
title Association of trainee participation with adenoma and polyp detection rates
title_full Association of trainee participation with adenoma and polyp detection rates
title_fullStr Association of trainee participation with adenoma and polyp detection rates
title_full_unstemmed Association of trainee participation with adenoma and polyp detection rates
title_short Association of trainee participation with adenoma and polyp detection rates
title_sort association of trainee participation with adenoma and polyp detection rates
topic Retrospective Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5437386/
https://www.ncbi.nlm.nih.gov/pubmed/28572874
http://dx.doi.org/10.4253/wjge.v9.i5.204
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