ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2015
Adjusting for patient demographics has minimal effects on rates of adenoma detection in a large, community-based setting.
Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Outcomes at follow-up of negative colonoscopy in average risk population: systematic review and meta-analysis.BMJ (Clinical research ed.) · 2019Pooled it
- Trial
- Observational
- The Impact of Computer-aided Detection Technology in Adenoma Detection Rate Among Experienced Endoscopists in the Community Setting.Journal of community hospital internal medicine perspectives · 2024Article
- Evaluating Different Approaches for Calculating Adenoma Detection Rate: Is Screening Colonoscopy the Gold Standard?Gastroenterology · 2023Article
- Unlocking quality in endoscopic mucosal resection.World journal of gastrointestinal endoscopy · 2023Review
- Quality of colonoscopy performed by medical or surgical specialists and trainees in five Australian hospitals.World journal of gastrointestinal endoscopy · 2022Article
- Causes of Socioeconomic Disparities in Colorectal Cancer and Intervention Framework and Strategies.Gastroenterology · 2020Review
- Accurate Identification of Colonoscopy Quality and Polyp Findings Using Natural Language Processing.Journal of clinical gastroenterology · 2019Article
- Physician characteristics associated with higher adenoma detection rate.Gastrointestinal endoscopy · 2018Article
- FITting ADR to colonoscopy indication.United European gastroenterology journal · 2017Article
- Article
- Colorectal Cancer Screening in Switzerland: Cross-Sectional Trends (2007-2012) in Socioeconomic Disparities.PloS one · 2015Article
- Adenoma Detection Rates for Screening Colonoscopies in Smokers and Obese Adults: Data From the New Hampshire Colonoscopy Registry.Journal of clinical gastroenterologyArticle
Corrections and comments
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Authors and funding
14 authors at 1 institution in 1 country.
Funding
Abstract
BACKGROUND &
aimsReliable estimates of adenoma detection rates (ADRs) are needed to inform colonoscopy quality standards, yet little is known about the contributions of patient demographics to variation in ADRs. We evaluated the effects of adjusting for patient age, race/ethnicity, and family history of colorectal cancer on variations in ADRs and the relative rank order of physicians.
methodsIn a retrospective cohort study, we collected data from Kaiser Permanente Northern California members who were ≥ 50 years old who received colonoscopies from 2006 through 2008. We evaluated ADRs (before and after adjustment for age, sex, race/ethnicity, and family history of colorectal cancer) for 102 endoscopists who performed 108,662 total colonoscopies and 20,792 screening colonoscopies. Adenomas were identified from the pathology database, and cancers were detected by using the Kaiser Permanente Northern California cancer registry.
resultsAbout two-thirds of examiners had unadjusted ADRs for screening exams that met gastroenterology society guidelines (>25% for men and >15% for women), although rates of detection varied widely (7.7%-61.5% for male patients and 1.7%-45.6% for female patients). Adjusting for case mix reduced the variation in detection rates (from 8-fold to 3-fold for male patients and from 27-fold to 5-fold for female patients), but the median change in physician order by detection rate was just 2 ranks, and few physicians changed quartiles of detection. For example, only 3 of 102 endoscopists moved into and 3 out of the lowest quartile of ADR.
conclusionsIn a community-based setting, most endoscopists met the ADR standards, although there was wide variation in ADRs, which was similar to that reported from academic and referral settings. Case-mix adjustment reduced variability but had only small effects on differences in ADRs between physicians, and only a small percentage of physicians changed quartiles of detection. Adjustments to ADRs are therefore likely only needed in settings in which physicians have very different patient demographics, such as in sex or age. Moderate differences in patient demographics between physicians are unlikely to substantially change rates of adenoma detection.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.