| Effect of simply recording colonoscopy withdrawal time on polyp and adenoma detection rates. | |
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MedLine Citation:
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PMID: 20363418 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: According to national recommendations, colonoscopy withdrawal time (WT) on negative screening examinations should average more than 6 minutes because this time is associated with a higher rate of polyp detection. Attempts have been made to increase the WT; however, simply knowing that a quality measure, such as the WT, is being monitored, by itself, may improve the quality of an examination. OBJECTIVE: To measure changes in the polyp detection rate associated with recording the WT. DESIGN: Retrospective. SETTING: Single tertiary care center. PATIENTS: Patients undergoing colonoscopy within 5 months immediately before (group A) and after (group B) initiation of WT recording. Colonoscopies were excluded if procedure times were incomplete, missing, or nonsensical. MAIN OUTCOME MEASUREMENTS: Polyp detection, compared by using the chi(2) test and logistic regression multivariate analyses; pathology manually reviewed from a sample of 200 consecutive polyp cases (100 per group). RESULTS: The average WT in group B was 14.5 minutes (11.0 minutes in negative screening examinations). In group A, polyps were detected in 530 (37.7%) of 1405 colonoscopies compared with 571 (41.2%) of 1387 colonoscopies in group B (difference 3.5%; 95% CI, -0.2% to 7.1%), a nonsignificant 9.3% relative increase. Longer procedure time, age, sex, and indication were significant predictors; monitoring the WT was not. Nonsignificantly, more polyp examinations in group B found all nonadenomas compared with group A (36% vs 27%; P = .17), and polyps were nonsignificantly smaller (P = .30). LIMITATIONS: Retrospective database data, pathology performed only on a subsample. CONCLUSION: WT recording was associated with a nonsignificant increase in polyp detection, but this was likely attributable to a slight increase in the detection of (smaller) nonadenomatous polyps. |
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Authors:
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Andrew Taber; Joseph Romagnuolo |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Gastrointestinal endoscopy Volume: 71 ISSN: 1097-6779 ISO Abbreviation: Gastrointest. Endosc. Publication Date: 2010 Apr |
Date Detail:
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Created Date: 2010-04-05 Completed Date: 2010-07-06 Revised Date: 2011-01-12 |
Medline Journal Info:
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Nlm Unique ID: 0010505 Medline TA: Gastrointest Endosc Country: United States |
Other Details:
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Languages: eng Pagination: 782-6 Citation Subset: IM |
Copyright Information:
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Copyright 2010 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved. |
Affiliation:
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Digestive Diseases Center, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adenoma
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diagnosis* Adult Aged Colonic Polyps / diagnosis* Colonoscopy / standards*, statistics & numerical data* Colorectal Neoplasms / diagnosis* Female Humans Male Mass Screening / standards*, statistics & numerical data* Middle Aged Multivariate Analysis Odds Ratio Retrospective Studies Sensitivity and Specificity Time and Motion Studies* |
| Comments/Corrections | |
Comment In:
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Gastrointest Endosc. 2010 Apr;71(4):787-8
[PMID:
20363419
]
Gastrointest Endosc. 2010 Apr;71(4):789-91 [PMID: 20363420 ] Gastrointest Endosc. 2011 Jan;73(1):189; author reply 189-90 [PMID: 21184888 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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