Background and Aims

Measurement of the adenoma detection rate (ADR) is resource intensive, and the benefit of continuous measurement for colonoscopists with high ADR is unclear. We examined the ADR trends at our center to determine whether continuous measurement for consistently high ADR is warranted.

Methods

Among colonoscopies performed between January 1999 and November 2019 at a tertiary center, we analyzed data from colonoscopists performing at least 50 screening colonoscopies annually for 5 consecutive years. ADR trends for individual colonoscopists were examined using Joinpoint regression models.

Results

Eleven colonoscopists performed screening colonoscopies on 14,047 patients, and 5912 among them had at least 1 conventional adenoma removed (42.0%). Of 25,829 polyps, 13,585 (52.6%) were conventional adenomas or adenocarcinomas and contributed to ADR calculation. All but 1 colonoscopist included met the recommended minimum threshold ADR of 25% continuously over the study period. Of the 11 colonoscopists, 5 had an increase in their ADR and the remaining 6 had stable ADRs over the study period.

Conclusions

For colonoscopists consistently performing above the minimum threshold, diversion of resources toward improvement of quality measures other than ADR is justified.

中文翻译：

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稳定或增加的腺瘤检出率对连续测量需求的影响

背景和目标

腺瘤检出率 (ADR) 的测量是资源密集型的，并且对于具有高 ADR 的结肠镜医师而言，连续测量的益处尚不清楚。我们检查了我们中心的 ADR 趋势，以确定是否有必要对持续的高 ADR 进行连续测量。

方法

在 1999 年 1 月至 2019 年 11 月期间在一家三级中心进行的结肠镜检查中，我们分析了结肠镜医师连续 5 年每年至少进行 50 次筛查结肠镜检查的数据。使用 Joinpoint 回归模型检查了个别结肠镜医师的 ADR 趋势。

结果

11 名结肠镜医师对 14,047 名患者进行了结肠镜检查，其中 5912 人至少切除了 1 个常规腺瘤（42.0%）。在 25,829 个息肉中，13,585 个（52.6%）是常规腺瘤或腺癌，并有助于 ADR 计算。在研究期间，除 1 名结肠镜医师外，所有患者均连续达到推荐的最低 ADR 阈值 25%。在研究期间，11 名结肠镜医师中，5 人的 ADR 增加，其余 6 人的 ADR 稳定。

结论

对于始终表现在最低阈值以上的结肠镜医师，将资源用于改进 ADR 以外的质量措施是合理的。