Evidence map›Paper›PMID 29803767›Full record

ArticleGastrointestinal endoscopy2018

Incidence of interval colorectal cancer attributable to an endoscopist in clinical practice.

Furkan U Ertem, Uri Ladabaum, Ateev Mehrotra, Shahrzad Tehranian, Zhuo Shi, Melissa Saul, Michele Morris, Seth D Crockett, Robert E Schoen

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Gastrointestinal endoscopy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

11 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
  8. Observational
  9. Interval Colorectal Cancer 2006-2015: Novel Observations.Digestive diseases and sciences · 2021
    Article
  10. Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Furkan U ErtemDepartment of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Uri LadabaumDivision of Gastroenterology, Stanford Medical School, Palo Alto, California, USA.
Ateev MehrotraDivision of Health Policy, Harvard Medical School, Cambridge, Massachusetts, USA.
Shahrzad TehranianDivision of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Zhuo ShiDivision of Health Policy, Harvard Medical School, Cambridge, Massachusetts, USA.
Melissa SaulDepartment of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Michele MorrisDepartment of Biomedical Informatics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Seth D CrockettDivision of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina, USA.
Robert E SchoenDivision of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

Funding

North Carolina Translational & Clinical Sciences Institute (NC TraCS)KL2TR001109 · NCATS · UNIV OF NORTH CAROLINA CHAPEL HILL · PI BUSE, JOHN BERNARD, CAREY, TIMOTHY S · 2013 to 2017
$5.7M
Measuring and Improving Colonoscopy Quality Using Natural Language ProcessingR01CA168959 · NCI · HARVARD MEDICAL SCHOOL · PI MEHROTRA, ATEEV · 2013 to 2016
$2.1M
NCATS NIH HHS KL2 TR001109NCI NIH HHS R01 CA168959
6 · The paper itself

Abstract

BACKGROUND AND

aimsEndoscopists who encounter an interval colorectal cancer (I-CRC) may be concerned about the implications because I-CRCs may represent a lapse in colonoscopy quality and a missed opportunity for prevention. We wanted to determine the I-CRC rate per colonoscopy examination and to examine the effect of colonoscopy volume and adenoma detection rate (ADR) on the number of I-CRCs attributable to an endoscopist.

methodsWe determined the rate of I-CRC diagnosis per outpatient colonoscopy examination by measuring the incidence of CRC diagnosis in practice and by assessing, via literature review, the percentage of cancers that are interval. We also estimated the number of attributable I-CRCs as a function of ADR and colonoscopy volume.

resultsAmong 93,562 colonoscopies performed in 2013 to 2015 by 120 physicians in 4 diverse U.S. medical centers, 526 CRCs were diagnosed (.6%). Of 149,556 CRCs in the published literature, 7958 were I-CRCs (5.25% ± .94%). With rates of .6% (CRC per colonoscopy) and 5.25% (I-CRC per CRC), the rate of I-CRC is 1 per 3174 colonoscopies (95% confidence interval, 1 per 2710 to 1 per 3875). An endoscopist at the median of outpatient colonoscopy volume (316/year) in the lowest ADR quintile of detection (7%-19%) would have an I-CRC attributed every 8.2 years, or 4.2 I-CRCs in a 35-year career, versus every 16.7 years, or 2.0 I-CRCs in a 35-year career, for an endoscopist in the highest ADR quintile (33%-52%).

conclusionsAn average-volume endoscopist will have 2 to 4 attributable I-CRCs in a 35-year career, but the frequency will vary depending on colonoscopy volume and ADR.

Indexed as

AdenomaAdultAgedCarcinomaColonoscopyColorectal NeoplasmsEarly Detection of CancerFemaleGastroenterologyHumansIncidenceMaleMiddle AgedQuality Indicators, Health Care

Identifiers

PMID29803767
PMCPMC6139042

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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.