Evidence map›Paper›PMID 40230559›Full record

ArticleEndoscopy international open2025

Differences in colonoscopy performance among four endoscopy centers in Western Norway: Influence of case-mix.

Tom Andre Pedersen, Trond Engjom, Georg Gjorgji Dimcevski, Edoardo Botteri, Birgitte Seip, Roald Flesland Havre

Abstract read
In one paragraph

Article in Endoscopy international open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

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

1 citing paper in PubMed.

  1. Trial
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.

Tom Andre PedersenDepartment of Medicine, Haukeland University Hospital, Bergen, Norway.ORCID 0009-0009-0290-0567
Trond EngjomDepartment of Medicine, Haukeland University Hospital, Bergen, Norway.
Georg Gjorgji DimcevskiDepartment of Medicine, Haukeland University Hospital, Bergen, Norway.
Edoardo BotteriSection for Colorectal Cancer screening, Cancer Registry of Norway, Oslo, Norway.
Birgitte SeipDepartment of Medicine, Vestfold Hospital Trust, Tonsberg, Norway.
Roald Flesland HavreDepartment of Medicine, Haukeland University Hospital, Bergen, Norway.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background and study aims: Unmodifiable patient factors such as age, sex, and indication (case-mix) may influence colonoscopy performance. In this study, we explored how case-mix affected polyp detection, cecal intubation, and pain on a center level. Methods: A cross-sectional study was performed on data from four centers in Western Norway registered in the national endoscopy quality registry, Gastronet, in 2020 and 2021. We extracted demographics, indication, and the performance measures cecal intubation rate (CIR), proportion of at least one polyp ≥ 5 mm in size per colonoscopy (PDR-5), and pain. We also analyzed the explanatory variables bowel preparation, withdrawal time, and sedation/analgesia. Results: First colonoscopies in 14,765 patients were included. Median age was 60 years (interquartile range 46-71) and 54% were women. Case-mix differed between centers and significantly influenced performance measures. Increased PDR-5 was associated with higher age and male sex (odds ratio [OR] 1.27, 95% confidence interval [CI] 1.18-1.37). The indication surveillance had the highest PDR-5 (44.9%, 95% CI 42.6-47.1) and inflammatory bowel disease the lowest (14.6%, 95% CI 12.3-16.8). CIR decreased with increasing age. Men had less pain (OR 0.33, 95% CI 0.27-0.39). Among indications, surveillance and IBD had higher CIRs and less pain. Performance measures differed among centers, even after adjustment for case-mix and other known explanatory variables such as sedation/analgesia and bowel preparation. Conclusions: Case-mix influenced performance measures. Although we showed center differences in performance, other factors, such as individual endoscopist skills, probably influence performance measures. Our study demonstrates the importance of considering case-mix when assessing colonoscopy performance.

Indexed as

Colorectal cancerCRC screeningEndoscopy Lower GI TractPolyps / adenomas / ...Quality and logistical aspectsQuality managementSedation and monitoring

Identifiers

PMID40230559
PMCPMC11996018

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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.