The effect of periodic monitoring and feedback on screening colonoscopy withdrawal times, polyp detection rates, and patient satisfaction scores

The water method significantly enhances proximal diminutive adenoma detection rate in unsedated patients

“…The air group overall ADR of 30% (Table 3) is comparable to those in studies employing standard equipment and techniques in sedated patients [15][16][17][18][19][20][21][22][23][24] (Table 5). The water group overall ADR of 38% (Table 3) could possibly exceed those in studies employing chromoendoscopy and standard colonoscope in sedated patients 25,26 ( Table 5).…”

“…In contrast to recent reports on evaluation of enhancement of ADR in sedated patients by new technologies 16,18,23,34,35 , focus on the withdrawal phase 10,21,22,25,26 and time of day 24 of colonoscopy or timing of bowel preparation 31 and removal of polyps during insertion 36 , we have described possible enhancement of proximal diminutive ADR on withdrawal in unsedated patients by the water method. Previous reports of worldwide availability of unsedated colonoscopy focused discussions on cecal intubation, patient tolerance, absence of sedation side-effects and potential cost savings 37 .…”

Colonoscopy Quality Assessment

“…Harewood et al provided quarterly feedback to a group of 58 endoscopists, and noted a 19% decline in incomplete colonoscopies 80 . Lin et al also reported that monitoring and feedback aided quality improvement, with increases in mean withdrawal time and polyp (but not adenoma) detection rate (33.1% to 38.1%, p=0.04) 81 . Implementation of a quarterly report card resulted in a significant increase in cecal intubation rate (98.1% vs 95.6%, p=0.027) and in ADR (53.9% vs 44.7%, p=0.013) 48 ; the increment in adenoma detection was mostly due to increased detection of proximal adenomas.…”

Benchmarking and quality-screening colonoscopy

“…13,14 Adenoma detection was not enhanced by narrow band imaging. 15,16 Feedback of monitoring results could increase polyp detection 17 but whether such measures will translate into increase in ADR is unknown. Increase in the total number of adenomas detected in the proximal colon in unblinded studies has been reported for the third eye retroscope.…”