ArticleGastrointestinal endoscopy2023
Impact of a scalable training program on the quality of colonoscopy performance and risk of postcolonoscopy colorectal cancer.
Article in Gastrointestinal endoscopy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Quality indicators for colonoscopy.Gastrointestinal endoscopy · 2024Guideline
- Adenoma detection rates during screening colonoscopy performed by interventional gastroenterologists and general gastroenterologists.iGIE : innovation, investigation and insights · 2026Article
- Colonoscopy Quality and Strategies for Improvement.Gut and liver · 2026Review
- Colonoscopy Quality Indicators in Transition: From Adenoma Detection Rate to Serrated Lesion Detection and Beyond.Diagnostics (Basel, Switzerland) · 2026Review
- Quality Indicators for Colonoscopy.The American journal of gastroenterology · 2024Article
- Strategies to improve screening colonoscopy quality for the prevention of colorectal cancer.The Korean journal of internal medicine · 2024Review
- Development and External Validation of a Prediction Model for Colorectal Cancer Among Patients Awaiting Surveillance Colonoscopy Following Polypectomy.Gastro hep advances · 2024Article
Corrections and comments
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Authors and funding
14 authors.
Funding
Abstract
BACKGROUND AND
aimsEndoscopist adenoma detection rates (ADRs) vary widely and are associated with patients' risk of postcolonoscopy colorectal cancers (PCCRCs). However, few scalable physician-directed interventions demonstrably both improve ADR and reduce PCCRC risk.
methodsAmong patients undergoing colonoscopy, we evaluated the influence of a scalable online training on individual-level ADRs and PCCRC risk. The intervention was a 30-minute, interactive, online training, developed using behavior change theory, to address factors that potentially impede detection of adenomas. Analyses included interrupted time series analyses for pretraining versus posttraining individual-physician ADR changes (adjusted for temporal trends) and Cox regression for associations between ADR changes and patients' PCCRC risk.
resultsAcross 21 endoscopy centers and all 86 eligible endoscopists, ADRs increased immediately by an absolute 3.13% (95% confidence interval [CI], 1.31-4.94) in the 3-month quarter after training compared with .58% per quarter (95% CI, .40-.77) and 0.33% per quarter (95% CI, .16-.49) in the 3-year pretraining and posttraining periods, respectively. Posttraining ADR increases were higher among endoscopists with pretraining ADRs below the median. Among 146,786 posttraining colonoscopies (all indications), each 1% absolute increase in screening ADR posttraining was associated with a 4% decrease in their patients' PCCRC risk (hazard ratio, .96; 95% CI, .93-.99). An ADR increase of ≥10% versus <1% was associated with a 55% reduced risk of PCCRC (hazard ratio, .45; 95% CI, .24-.82).
conclusionsA scalable, online behavior change training intervention focused on modifiable factors was associated with significant and sustained improvements in ADR, particularly among endoscopists with lower ADRs. These ADR changes were associated with substantial reductions in their patients' risk of PCCRC.
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