Can polyp detection rate be used prospectively as a marker of adenoma detection rate?

Murchie, Brent; Tandon, Kanwarpreet; Zackria, Shamiq; Wexner, Steven D.; O’Rourke, Colin; Castro, Fernando

doi:10.1007/s00464-017-5785-5

Cited by 16 publications

(11 citation statements)

References 23 publications

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“…Currently, no consensus values exist for the ADQ and the SSA/P-DQ due to potential for variation in different settings. The ADQ found in our study (i.e., 0.68) was consistent with what was found in recent studies from Murchie et al [21] (i.e., 0.66-0.67) and Elhanafi et al [20] (i.e., 0.68). This lends support to the use of this quotient in Australia.…”

Section: Discussion/conclusionsupporting

confidence: 93%

“…Although calculating both the ADR and SSA/P-DR makes intuitive sense and could and perhaps should be used as a measure of quality, both measures have not been used widely possibly due to the additional effort required (tracking histology of every single polyp removed). Some studies have proposed the use of a quotient based on the polyp detection rate (PDR) to promptly predict the ADR, negating the need to track the final histology [18][19][20][21]. If consistent, the adoption of quotient values could enable swift calculation of ADR and SSA/P-DR for endoscopists and regulatory bodies, allowing for an effective performance evaluation tool.…”

Section: Introductionmentioning

confidence: 99%

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Polyp Detection Rate as a Surrogate for Adenoma and Sessile Serrated Adenoma/Polyp Detection Rates

Singh

Rana

et al. 2020

Gastrointest Tumors

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Introduction: Quality measures for colonoscopy such as adenoma detection rate (ADR) have been proposed to be surveilled for ensuring minimum standards. However, its direct measurement is time consuming and often neglected. Extrapolating ADR and other quality measures from polyp detection rate (PDR) can be a pragmatic alternative. Objective: To determine quotients for estimating ADR and sessile serrated adenoma/polyp detection rate (SSA/P-DR) from PDR in an Australian cohort. Methods: Consecutive adult patient colonoscopies during a 1-year period were retrospectively assessed in a single Australian tertiary endoscopy center. Adenoma detection quotient (ADQ) and SSA/P detection quotient (SSA/P-DQ) were defined as the division of ADR and SSA/P-DR by PDR, respectively. The primary outcome was the number of procedures to achieve a stable cumulative ADQ and SSA/P-DQ. Secondary outcomes included evaluation of ADQ and SSA/P-DQ in different subsets. Results: In total, 2,657 colonoscopies were performed by 15 endoscopists in 2016. The ADR, SSA/P-DR, and PDR found were 32.2, 6.7, and 47.3%, respectively. The ADQ and SSA/P-DQ values found were 0.68 and 0.14, respectively. After approximately 500 procedures, both ADQ and SSA/P-DQ became stable. Interclass correlation coefficient (ICC) for the prediction of ADR from ADQ was excellent for all endoscopists that performed >177 procedures in that year (ICC 0.84). Conclusions: ADQ and SSA/P-DQ values were consistent when over 500 procedures were analyzed. ADQ had an excellent correlation with ADR when >177 procedures per endoscopist were evaluated.

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Section: Discussion/conclusionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Polyp Detection Rate as a Surrogate for Adenoma and Sessile Serrated Adenoma/Polyp Detection Rates

Singh

Rana

et al. 2020

Gastrointest Tumors

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“…Many publications have suggested conversion factors to give an estimated ADR. 19 20 An earlier study suggested using a conversion factor of 0.68 for estimating ADR and 0.14 for SSPDR. Our data show a lower conversion factor (mean 0.51) that varied from 0.41 to 0.59 between endoscopists ( table 1 ).…”

Section: Discussionmentioning

confidence: 99%

Improved detection of adenomas and sessile serrated polyps is maintained with continuous audit of colonoscopy

Fraser

Rose²,

Wong³

et al. 2020

BMJ Open Gastroenterol

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BackgroundThe audit process may help improve performance indicators for colonoscopy quality but it is unclear whether this is sustained over several years.Methods44138 procedures for 28 endoscopists from 2004 to 2019 were analysed for polyp detection rate and withdrawal time. From 2012, 14 endoscopists were analysed with additional data on polyp histology and number of polyps removed.ResultsPolyp detection increased from 40.7% in 2004 to 62.2% in 2019; removal of polyps>1 cm remained constant (11%). Adenoma detection rate was 25.8% in 2012 and 28.3% in 2019. Sessile serrated polyp (SSP) detection rate increased from 4.5% to 14.7%; most of the increase was in the first 2 years of the histology part of the audit. There was a significant correlation of adenoma detection rate with mean number of adenomas (r=0.72, p=0.004) and a significant correlation of SSP detection with mean number of SSPs (r=0.85, p=0.0001).ConclusionThe audit process appears to encourage a higher rate of polyp detection. This was due to increased detection of smaller polyps and increased detection of SSPs.

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“…ADR is recommended to be 15 % or more with an aspirational ADR of 20 %. The polyp detection rate can be used as a marker of ADR [16,19] In the 2017 JAG census, shortages of endoscopists and nursing staff were found to be the biggest barrier that impeded units in meeting the demand [18]. Services introduced extended working hours during the week and on weekends to increase capacity; 66 % of acute NHS units perform endoscopy most or every weekend.…”

Section: Methodsmentioning

confidence: 99%

Weekend and evening planned colonoscopy activity: a safe and effective way to meet demands

et al. 2021

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Background and study aims Colonoscopy is the “gold standard” investigation for assessment of the large bowel that detects and prevents colorectal cancer, as well as non-neoplastic conditions. The Joint Advisory Group (JAG) on Gastrointestinal Endoscopy recommends monitoring key performance indicators such as cecal intubation rate (CIR) and adenoma detection rate (ADR). We aimed to investigate the quality of colonoscopies carried out during evening and Saturday lists in our unit and compare them against JAG standards of quality for colonoscopies. Patients and methods We retrospectively collected and analyzed demographical and procedure-related data for non-screening colonoscopies performed between January 2016 and November 2018. Evenings and Saturdays were defined as the out-of-hour (OOH) period. We compared the outcomes of the procedures done in these against the working hours of the weekdays. We also wanted to explore whether the outcomes were different among certain endoscopists. Other factors that could affect the KPIs, such as endoscopist experience and bowel preparation, were also analyzed. Results There were a total of 17634 colonoscopies carried out; 56.9 % of the patients (n = 10041) < 70 years old. Key Performance Indicators (KPIs) of weekday, evening, and Saturday colonoscopies regarding the CIR and ADR met the JAG standards as they were above 93 % and 24 %, respectively. Advanced colonoscopists had better KPIs when compared to the non-advanced colonoscopists, with CIR at 97.6 % vs. 93.2 % and ADR at 40.8 % vs. 26 %, respectively. Conclusions JAG standards were maintained during colonoscopies done on weekdays, evenings, and Saturdays. Advanced colonoscopists had higher CIR and ADRs.

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Can polyp detection rate be used prospectively as a marker of adenoma detection rate?

Abstract: Monthly report cards did not result in a change in PDR or APDRQ. In some environments, PDR can be used as a surrogate marker of ADR, despite endoscopist awareness that PDR is being measured.

Cited by 16 publications

References 23 publications

Polyp Detection Rate as a Surrogate for Adenoma and Sessile Serrated Adenoma/Polyp Detection Rates

Polyp Detection Rate as a Surrogate for Adenoma and Sessile Serrated Adenoma/Polyp Detection Rates

Improved detection of adenomas and sessile serrated polyps is maintained with continuous audit of colonoscopy

Weekend and evening planned colonoscopy activity: a safe and effective way to meet demands

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