Trainee participation and adenoma detection rates during screening colonoscopies Journal Article

Authors: Chalifoux, S. L.; Rao, D. S.; Wani, S. B.; Sharma, P; Bansal, A; Gupta, N; Rastogi, A
Article Title: Trainee participation and adenoma detection rates during screening colonoscopies
Abstract: GOAL: To evaluate whether participation of a gastroenterology trainee had an impact on adenoma detection rate (ADR) during screening colonoscopies performed with standard-definition colonoscopes (SD-C) versus high-definition colonoscopes (HD-C). BACKGROUND: ADR is an established quality indicator of colonoscopy and efforts to improve ADR have led to technological advancements including HD-C that have a greater angle of view and produce an image with higher pixel density compared with SD-C. Moreover, other factors like trainee participation have been shown to improve adenoma detection. METHODS: This is a retrospective review of screening colonoscopies performed during 2 different time periods by 4 experienced endoscopists with or without trainee participation. There are 2 arms of this study, based on whether screening colonoscopy was performed using SD-C or HD-C. Detailed review of endoscopy and histopathologic reports was conducted. Statistical analysis was performed and odds ratio and incidence rate ratios were calculated to adjust for numerous factors. RESULTS: No significant differences were seen with trainee participation in the SD-C arm of the study. In the HD-C arm, the total number, and the proportion of subjects with: adenomas, diminutive adenomas, and right-sided adenomas were significantly higher with trainee participation. CONCLUSIONS: Trainee participation significantly improved the overall adenoma detection, specifically diminutive adenoma and right-sided adenoma detection, but only when colonoscopies were performed with HD-C. The improved image quality and resolution provided by HD-C, coupled with enhanced visual scanning an additional pair of eyes provides, may account for the differential impact of trainee participation on ADR.
Journal Title: Journal of clinical gastroenterology
Volume: 48
Issue: 6
ISSN: 1539-2031; 0192-0790
Publisher: Unknown  
Journal Place: United States
Date Published: 2014
Start Page: 524
End Page: 529
Language: eng
Notes: JID: 7910017; ppublish