Evidence map›Paper›PMID 34332538›Full record

Observational studyBMC gastroenterology2021

Cecal retroflexion is infrequently performed in routine practice and the retroflexed view is of poor quality.

Rajesh N Keswani, Charles J Kahi, Mark Benson, Andrew J Gawron, Tonya R Kaltenbach, Rena H Yadlapati, Dyanna L Gregory, Anna Duloy

Open access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC gastroenterology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.3field-weighted citation impact, top 41% 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

0 citing papers in PubMed, 4 citations in OpenAlex.

No citing paper in PubMed yet.

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

8 authors at 7 institutions in 1 country.

Rajesh N KeswaniDepartment of Gastroenterology and Hepatology, Northwestern University, 676 N. St. Clair, Suite 1400, Chicago, IL, 60611, USA. raj-keswani@northwestern.edu.
Charles J KahiDepartment of Gastroenterology, Indiana University Medical Center, Indianapolis, USA.
Mark BensonDepartment of Gastroenterology and Hepatology, School of Medicine and Public Health, University of Wisconsin, Madison, USA.
Andrew J GawronDepartment of Gastroenterology, University of Utah, Salt Lake City, USA.
Tonya R KaltenbachDepartment of Gastroenterology, University of California, San Francisco, USA.
Rena H YadlapatiDivision of Gastroenterology, University of California, San Diego School of Medicine, La Jolla, USA.
Dyanna L GregoryDepartment of Gastroenterology and Hepatology, Northwestern University, 676 N. St. Clair, Suite 1400, Chicago, IL, 60611, USA.
Anna DuloyDepartment of Gastroenterology, University of Colorado, Boulder, USA.
Northwestern University · USIndiana University – Purdue University Indianapolis · USUniversity of California, San Diego · USUniversity of California, San Francisco · USUniversity of Colorado Boulder · USUniversity of Utah · USUniversity of Wisconsin–Madison · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAs right colon polyps are challenging to detect, a retroflexed view of right colon (RV) may be useful. However, cecal retroflexion (CR) without a RV to the hepatic flexure (HF) is inadequate. We aimed to determine the frequency of CR and quality of the RV in routine practice.

methodsThis prospective observational study performed at an academic medical center assessed colonoscopy inspection technique of endoscopists who had performed ≥ 100 annual screening colonoscopies. We video recorded ≥ 28 screening/surveillance colonoscopies per endoscopist and randomly evaluated 7 videos per endoscopist. Six gastroenterologists blindly reviewed the videos to determine if CR was performed and HF withdrawal time (cecum to HF time, excluding ileal/polypectomy time).

resultsReviewers assessed 119 colonoscopies performed by 17 endoscopists. The median HF withdrawal time was 3 min and 46 s. CR was performed in 31% of colonoscopies. CR frequency varied between endoscopists with 9 never performing CR and 2 performing CR in all colonoscopies. When performed, nearly half (43%) of RVs did not extend to the HF with median RV duration of 16 s (IQR 9-30 s). Three polyps were identified in the RV (polyp detection rate of 8.1%), all identified prior to a forward view.

conclusionsCR is performed infrequently in routine practice. When CR is performed, the RV is of low quality with a very short inspection duration and insufficient ascending colon examination. Further education is required to educate endoscopists in optimal technique to improve overall colonoscopy quality.

Indexed as

AdenomaColonic PolypsCecumColon, AscendingColonoscopyHumansQualityRetroflexionRight colon

Identifiers

PMID34332538
PMCPMC8325794
OpenAlexW3190153227

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.