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Adenoma detection rate is enough to assess endoscopist performance: a population-based observational study of FIT-positive colonoscopies

Background and study aims  Neoplasia-related indicators, such as adenoma detection rate (ADR), are a priority in the quality improvement process for colonoscopy. Our aim was to assess and compare different detection and characterization indicators in fecal immunochemical test (FIT)-positive colonosc...

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Autores principales: Denis, Bernard, Gendre, Isabelle, Tuzin, Nicolas, Murris, Juliette, Guignard, Anne, Perrin, Philippe, Rahmi, Gabriel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Georg Thieme Verlag KG 2022
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9473817/
https://www.ncbi.nlm.nih.gov/pubmed/36118642
http://dx.doi.org/10.1055/a-1859-8277
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author Denis, Bernard
Gendre, Isabelle
Tuzin, Nicolas
Murris, Juliette
Guignard, Anne
Perrin, Philippe
Rahmi, Gabriel
author_facet Denis, Bernard
Gendre, Isabelle
Tuzin, Nicolas
Murris, Juliette
Guignard, Anne
Perrin, Philippe
Rahmi, Gabriel
author_sort Denis, Bernard
collection PubMed
description Background and study aims  Neoplasia-related indicators, such as adenoma detection rate (ADR), are a priority in the quality improvement process for colonoscopy. Our aim was to assess and compare different detection and characterization indicators in fecal immunochemical test (FIT)-positive colonoscopies, to determine associated factors, and to propose benchmarks. Patients and methods  Retrospective analysis of prospectively collected data from all colonoscopies performed between 2015 and 2019 after a positive quantitative FIT in the population-based colorectal cancer screening program conducted in Alsace, part of the French national program. Detection indicators included ADR, mean number of adenomas per colonoscopy, and proximal serrated lesion (SL) detection rate. Characterization indicators included rate of non-neoplastic polyp (NNP) detection. Results  Overall, 13,067 FIT-positive colonoscopies were evaluated, performed by 80 community gastroenterologists. The overall ADR was 57.6 %, and a 10 µg/g increase in fecal hemoglobin concentration was significantly associated with higher ADR (odds ratio [95 % confidence interval] = 1.02 [1.02–1.03]). Endoscopists whose ADR was ≥ 55 % were high detectors for all neoplasia, including proximal SLs and number of adenomas. The rate of detection of NNPs was 39.5 % in highest detectors (ADR > 70 %), significantly higher than in lower detectors (21.4 %) ( P  < 0.001). There was a strong correlation between detection and characterization indicators, e. g. between rates of detection of proximal SLs and NNPs (Pearson = 0.73; P  < 0.01). Conclusions  A single indicator, ADR, is enough to assess endoscopist performance for both detection and characterization in routine practice provided the minimum target standard is raised and a maximum standard is added: 55 % and 70 % for FIT-positive colonoscopies, respectively.
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spelling pubmed-94738172022-09-15 Adenoma detection rate is enough to assess endoscopist performance: a population-based observational study of FIT-positive colonoscopies Denis, Bernard Gendre, Isabelle Tuzin, Nicolas Murris, Juliette Guignard, Anne Perrin, Philippe Rahmi, Gabriel Endosc Int Open Background and study aims  Neoplasia-related indicators, such as adenoma detection rate (ADR), are a priority in the quality improvement process for colonoscopy. Our aim was to assess and compare different detection and characterization indicators in fecal immunochemical test (FIT)-positive colonoscopies, to determine associated factors, and to propose benchmarks. Patients and methods  Retrospective analysis of prospectively collected data from all colonoscopies performed between 2015 and 2019 after a positive quantitative FIT in the population-based colorectal cancer screening program conducted in Alsace, part of the French national program. Detection indicators included ADR, mean number of adenomas per colonoscopy, and proximal serrated lesion (SL) detection rate. Characterization indicators included rate of non-neoplastic polyp (NNP) detection. Results  Overall, 13,067 FIT-positive colonoscopies were evaluated, performed by 80 community gastroenterologists. The overall ADR was 57.6 %, and a 10 µg/g increase in fecal hemoglobin concentration was significantly associated with higher ADR (odds ratio [95 % confidence interval] = 1.02 [1.02–1.03]). Endoscopists whose ADR was ≥ 55 % were high detectors for all neoplasia, including proximal SLs and number of adenomas. The rate of detection of NNPs was 39.5 % in highest detectors (ADR > 70 %), significantly higher than in lower detectors (21.4 %) ( P  < 0.001). There was a strong correlation between detection and characterization indicators, e. g. between rates of detection of proximal SLs and NNPs (Pearson = 0.73; P  < 0.01). Conclusions  A single indicator, ADR, is enough to assess endoscopist performance for both detection and characterization in routine practice provided the minimum target standard is raised and a maximum standard is added: 55 % and 70 % for FIT-positive colonoscopies, respectively. Georg Thieme Verlag KG 2022-09-14 /pmc/articles/PMC9473817/ /pubmed/36118642 http://dx.doi.org/10.1055/a-1859-8277 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 commercial 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 Denis, Bernard
Gendre, Isabelle
Tuzin, Nicolas
Murris, Juliette
Guignard, Anne
Perrin, Philippe
Rahmi, Gabriel
Adenoma detection rate is enough to assess endoscopist performance: a population-based observational study of FIT-positive colonoscopies
title Adenoma detection rate is enough to assess endoscopist performance: a population-based observational study of FIT-positive colonoscopies
title_full Adenoma detection rate is enough to assess endoscopist performance: a population-based observational study of FIT-positive colonoscopies
title_fullStr Adenoma detection rate is enough to assess endoscopist performance: a population-based observational study of FIT-positive colonoscopies
title_full_unstemmed Adenoma detection rate is enough to assess endoscopist performance: a population-based observational study of FIT-positive colonoscopies
title_short Adenoma detection rate is enough to assess endoscopist performance: a population-based observational study of FIT-positive colonoscopies
title_sort adenoma detection rate is enough to assess endoscopist performance: a population-based observational study of fit-positive colonoscopies
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9473817/
https://www.ncbi.nlm.nih.gov/pubmed/36118642
http://dx.doi.org/10.1055/a-1859-8277
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