Evidence map›Paper›PMID 28444509›Full record

Trial reportDigestive diseases and sciences2017

Impact of an Endoscopic Quality Improvement Program Focused on Adenoma Detection on Sessile Serrated Adenoma/Polyp Detection.

Ronald G Racho, Murli Krishna, Susan G Coe, Colleen S Thomas, Julia E Crook, Nancy N Diehl, Michael B Wallace

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Digestive diseases and sciences, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
0.6field-weighted citation impact, top 31% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Management of Serrated Polyps of the Colon.Current treatment options in gastroenterology · 2018
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 1 country.

Ronald G RachoDepartment of Internal Medicine, Mayo Clinic, Jacksonville, FL, USA.
Murli KrishnaDepartment of Pathology, Mayo Clinic, Jacksonville, FL, USA.
Susan G CoeAtlanta Gastroenterology Associates, Snellville, GA, USA.
Colleen S ThomasDivision of Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, FL, USA.
Julia E CrookDivision of Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, FL, USA.
Nancy N DiehlDivision of Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, FL, USA.
Michael B WallaceDivision of Gastroenterology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA. wallace.michael@mayo.edu.
WinnMed · USMayo Clinic in Florida · USAtlanta Gastroenterology Associates · USJacksonville College · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSessile serrated adenomas/polyps (SSA/P) are an under-recognized disease with a unique malignant pathway. Improved endoscopic recognition and pathological interpretation is needed.

aimsTo determine whether an educational intervention that improved adenoma detection rate (ADR) could improve SSA/P detection rate after reclassification of previously termed "hyperplastic" polyps.

methodsWe reanalyzed data from a prospective randomized trial of an educational intervention aimed at increasing ADR. All hyperplastic polyps ≥6 mm reported in a previously published study were rereviewed and reclassified using standardized criteria for serrated lesions. Detection rates of sessile serrated adenomas/polyps and other clinically relevant serrated polyps were calculated in the baseline and post-training phases of the original study.

resultsOf 263 available for rereview, 33 (12.5%) were reclassified as SSA/P (N = 32) or traditional serrated adenoma (TSA) (N = 1). Reclassification was more common in the right colon (18 vs. 8%, p = 0.02). Baseline SSA/P detection rate was 0.7% in the untrained group and 1.3% in the trained group. Post-training, the SSA/P detection rate increased to 2.1 and 1.5%, respectively. The clinically relevant serrated polyp detection rate at baseline was 14.2% in the untrained group and 11.3% in the trained group. After the educational intervention, the clinically relevant serrated polyp detection rates increased to 16.5 and 14.8% in the untrained and trained groups, respectively. The estimated odds of an endoscopist detecting either a SSA/P or other clinically relevant serrated polyp during colonoscopy increased by only 3% with the educational intervention (OR 1.03, 95% CI 0.61-1.74, p = 0.91).

conclusionsPathological re-interpretation of larger serrated polyps resulted in the reclassification of 12.5% of lesions. Quality improvement methods focused on adenoma detection did not impact SSA/P detection, and thus specific methods for serrated polyp detection are needed.

Indexed as

Quality ImprovementAdenomaColonic PolypsColonoscopyColorectal NeoplasmsHumansHyperplasiaProspective StudiesRetrospective StudiesTumor BurdenAdenoma detection rateColonoscopyColorectal cancer preventionSerrated polyps

Identifiers

PMID28444509
OpenAlexW2609557631

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.