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Educational interventions are associated with improvements in colonoscopy quality indicators: a systematic review and meta-analysis

Background and study aims  The quality of screening-related colonoscopy depends on several physician- and patient-related factors. Adenoma detection rate (ADR) varies considerably between endoscopists. Educational interventions aim to improve endoscopists’ ADRs, but their overall impact is uncertain...

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Autores principales: Causada-Calo, Natalia S., Gonzalez-Moreno, Emmanuel I., Bishay, Kirles, Shorr, Risa, Dube, Catherine, Heitman, Steven J., Hilsden, Robert J., Rostom, Alaa, Walsh, Catharine, Anderson, John T., Keswani, Rajesh N., Scaffidi, Michael A., Grover, Samir C., Forbes, Nauzer
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Georg Thieme Verlag KG 2020
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7508648/
https://www.ncbi.nlm.nih.gov/pubmed/33015334
http://dx.doi.org/10.1055/a-1221-4922
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author Causada-Calo, Natalia S.
Gonzalez-Moreno, Emmanuel I.
Bishay, Kirles
Shorr, Risa
Dube, Catherine
Heitman, Steven J.
Hilsden, Robert J.
Rostom, Alaa
Walsh, Catharine
Anderson, John T.
Keswani, Rajesh N.
Scaffidi, Michael A.
Grover, Samir C.
Forbes, Nauzer
author_facet Causada-Calo, Natalia S.
Gonzalez-Moreno, Emmanuel I.
Bishay, Kirles
Shorr, Risa
Dube, Catherine
Heitman, Steven J.
Hilsden, Robert J.
Rostom, Alaa
Walsh, Catharine
Anderson, John T.
Keswani, Rajesh N.
Scaffidi, Michael A.
Grover, Samir C.
Forbes, Nauzer
author_sort Causada-Calo, Natalia S.
collection PubMed
description Background and study aims  The quality of screening-related colonoscopy depends on several physician- and patient-related factors. Adenoma detection rate (ADR) varies considerably between endoscopists. Educational interventions aim to improve endoscopists’ ADRs, but their overall impact is uncertain. We aimed to assess whether there is an association between educational interventions and colonoscopy quality indicators. Methods  A comprehensive search was performed through August 2019 for studies reporting any associations between educational interventions and any colonoscopy quality indicators. Our primary outcome of interest was ADR. Two authors assessed eligibility criteria and extracted data independently. Risk of bias was also assessed for included studies. Pooled rate ratios (RR) with 95 % confidence intervals (CI) were reported using DerSimonian and Laird random effects models. Results  From 2,253 initial studies, eight were included in the meta-analysis for ADR, representing 86,008 colonoscopies. Educational interventions were associated with improvements in overall ADR (RR 1.29, 95 % CI 1.25 to 1.42, 95 % prediction interval 1.09 to 1.53) and proximal ADR (RR 1.39, 95 % CI 1.29 to 1.48), with borderline increases in withdrawal time, ([WT], mean difference 0.29 minutes, 95 % CI – 0.12 to 0.70 minutes). Educational interventions did not affect cecal intubation rate ([CIR], RR 1.01, 95 % CI 1.00 to 1.01). Heterogeneity was considerable across many of the analyses. Conclusions  Educational interventions are associated with significant improvements in ADR, in particular, proximal ADR, and are not associated with improvements in WT or CIR. Educational interventions should be considered an important option in quality improvement programs aiming to optimize the performance of screening-related colonoscopy.
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spelling pubmed-75086482020-10-01 Educational interventions are associated with improvements in colonoscopy quality indicators: a systematic review and meta-analysis Causada-Calo, Natalia S. Gonzalez-Moreno, Emmanuel I. Bishay, Kirles Shorr, Risa Dube, Catherine Heitman, Steven J. Hilsden, Robert J. Rostom, Alaa Walsh, Catharine Anderson, John T. Keswani, Rajesh N. Scaffidi, Michael A. Grover, Samir C. Forbes, Nauzer Endosc Int Open Background and study aims  The quality of screening-related colonoscopy depends on several physician- and patient-related factors. Adenoma detection rate (ADR) varies considerably between endoscopists. Educational interventions aim to improve endoscopists’ ADRs, but their overall impact is uncertain. We aimed to assess whether there is an association between educational interventions and colonoscopy quality indicators. Methods  A comprehensive search was performed through August 2019 for studies reporting any associations between educational interventions and any colonoscopy quality indicators. Our primary outcome of interest was ADR. Two authors assessed eligibility criteria and extracted data independently. Risk of bias was also assessed for included studies. Pooled rate ratios (RR) with 95 % confidence intervals (CI) were reported using DerSimonian and Laird random effects models. Results  From 2,253 initial studies, eight were included in the meta-analysis for ADR, representing 86,008 colonoscopies. Educational interventions were associated with improvements in overall ADR (RR 1.29, 95 % CI 1.25 to 1.42, 95 % prediction interval 1.09 to 1.53) and proximal ADR (RR 1.39, 95 % CI 1.29 to 1.48), with borderline increases in withdrawal time, ([WT], mean difference 0.29 minutes, 95 % CI – 0.12 to 0.70 minutes). Educational interventions did not affect cecal intubation rate ([CIR], RR 1.01, 95 % CI 1.00 to 1.01). Heterogeneity was considerable across many of the analyses. Conclusions  Educational interventions are associated with significant improvements in ADR, in particular, proximal ADR, and are not associated with improvements in WT or CIR. Educational interventions should be considered an important option in quality improvement programs aiming to optimize the performance of screening-related colonoscopy. Georg Thieme Verlag KG 2020-10 2020-09-22 /pmc/articles/PMC7508648/ /pubmed/33015334 http://dx.doi.org/10.1055/a-1221-4922 Text en The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/) https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.
spellingShingle Causada-Calo, Natalia S.
Gonzalez-Moreno, Emmanuel I.
Bishay, Kirles
Shorr, Risa
Dube, Catherine
Heitman, Steven J.
Hilsden, Robert J.
Rostom, Alaa
Walsh, Catharine
Anderson, John T.
Keswani, Rajesh N.
Scaffidi, Michael A.
Grover, Samir C.
Forbes, Nauzer
Educational interventions are associated with improvements in colonoscopy quality indicators: a systematic review and meta-analysis
title Educational interventions are associated with improvements in colonoscopy quality indicators: a systematic review and meta-analysis
title_full Educational interventions are associated with improvements in colonoscopy quality indicators: a systematic review and meta-analysis
title_fullStr Educational interventions are associated with improvements in colonoscopy quality indicators: a systematic review and meta-analysis
title_full_unstemmed Educational interventions are associated with improvements in colonoscopy quality indicators: a systematic review and meta-analysis
title_short Educational interventions are associated with improvements in colonoscopy quality indicators: a systematic review and meta-analysis
title_sort educational interventions are associated with improvements in colonoscopy quality indicators: a systematic review and meta-analysis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7508648/
https://www.ncbi.nlm.nih.gov/pubmed/33015334
http://dx.doi.org/10.1055/a-1221-4922
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