Evidence map›Paper›PMID 35581662›Full record

ArticleBMC medical informatics and decision making2022

Clinician based decision tool to guide recommended interval between colonoscopies: development and evaluation pilot study.

Leigh Anne Shafer, Gayle Restall, Alexandria Simms, Eugene Lee, Jason Park, Harminder Singh

Abstract read
In one paragraph

Article in BMC medical informatics and decision making, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing 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

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

  1. Quality indicators for colonoscopy.Gastrointestinal endoscopy · 2024
    Guideline
  2. Review
  3. Quality Indicators for Colonoscopy.The American journal of gastroenterology · 2024
    Article
  4. Article
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

6 authors.

Leigh Anne ShaferSection of Gastroenterology, Department of Internal Medicine, Rady Faculty of Health Sciences, University of Manitoba, 805-715 McDermot Avenue, Winnipeg, MB, R3E3P4, Canada.
Gayle RestallDepartment of Occupational Therapy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.
Alexandria SimmsDepartment of Occupational Therapy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.
Eugene LeeSection of Gastroenterology, Department of Internal Medicine, Rady Faculty of Health Sciences, University of Manitoba, 805-715 McDermot Avenue, Winnipeg, MB, R3E3P4, Canada.
Jason ParkSection of Gastroenterology, Department of Internal Medicine, Rady Faculty of Health Sciences, University of Manitoba, 805-715 McDermot Avenue, Winnipeg, MB, R3E3P4, Canada.
Harminder SinghSection of Gastroenterology, Department of Internal Medicine, Rady Faculty of Health Sciences, University of Manitoba, 805-715 McDermot Avenue, Winnipeg, MB, R3E3P4, Canada. Harminder.singh@umanitoba.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOptimal intervals between repeat colonoscopies could improve patient outcomes and reduce costs. We evaluated: (a) concordance between clinician and guideline recommended colonoscopy screening intervals in Winnipeg, Manitoba, (b) clinician opinions about the utility of an electronic decision-making tool to aid in recommending screening intervals, and (c) the initial use of a decision-making smartphone/web-based application.

methodsClinician endoscopists and primary care providers participated in four focus groups (N = 22). We asked participating clinicians to evaluate up to 12 hypothetical scenarios and compared their recommended screening interval to those of North American guidelines. Fisher's exact tests were used to assess differences in agreement with guidelines. We developed a decision-making tool and evaluated it via a pilot study with 6 endoscopists.

result53% of clinicians made recommendations that agreed with guidelines in ≤ 50% of the hypothetical scenarios. Themes from focus groups included barriers to using a decision-making tool: extra time to use it, less confidence in the results of the tool over their own judgement, and having access to the information required by the tool (e.g., family history). Most were willing to try a tool if it was quick and easy to use. Endoscopists participating in the tool pilot study recommended screening intervals discordant with guidelines 35% of the time. When their recommendation differed from that of the tool, they usually endorsed their own over the guideline.

conclusionsEndoscopists are overconfident and inconsistent with applying guidelines in their polyp surveillance interval recommendations. Use of a decision tool may improve knowledge and application of guidelines. A change in practice may require that the tool be coupled with continuing education about evidence for improved outcomes if guidelines are followed.

Indexed as

ColonoscopyColorectal NeoplasmsEarly Detection of CancerHumansMass ScreeningPilot ProjectsColon polypsColorectal cancerGuidelines

Identifiers

PMID35581662
PMCPMC9112638

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Registered trials

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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.