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Quality colonoscopy

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https://www.readbyqxmd.com/read/28428714/predictors-for-difficult-cecal-insertion-in-colonoscopy-the-impact-of-obesity-indices
#1
Soo Yun Moon, Byung Chang Kim, Dae Kyung Sohn, Kyung Su Han, Bun Kim, Chang Won Hong, Bum Joon Park, Kum Hei Ryu, Ji Hyung Nam
AIM: To identify the factors influencing cecal insertion time (CIT) and to evaluate the effect of obesity indices on CIT. METHODS: We retrospectively reviewed the data for participants who received both colonoscopy and abdominal computed tomography (CT) from February 2008 to May 2008 as part of a comprehensive health screening program. Age, gender, obesity indices [body mass index (BMI), waist-to-hip circumference ratio (WHR), waist circumference (WC), visceral adipose tissue (VAT) volume and subcutaneous adipose tissue (SAT) volume on abdominal CT], history of prior abdominal surgery, constipation, experience of the colonoscopist, quality of bowel preparation, diverticulosis and time required to reach the cecum were analyzed...
April 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28428142/increased-rate-of-adenoma-detection-associates-with-reduced-risk-of-colorectal-cancer-and-death
#2
M F Kaminski, P Wieszczy, M Rupinski, U Wojciechowska, J Didkowska, E Kraszewska, J Kobiela, R Franczyk, M Rupinska, B Kocot, A Chaber-Ciopinska, J Pachlewski, M Polkowski, J Regula
BACKGROUND & AIMS: Quality of endoscopists' performance of colonoscopy is measured by adenoma detection rate (ADR). Although ADR is inversely associated with interval colorectal cancer and colorectal cancer death, the effects of increasing ADR have not been demonstrated. We investigated whether increasing ADRs from individual endoscopists associates with reduced risks of interval colorectal cancer and subsequent death METHODS: We performed a prospective cohort study of individuals who underwent screening colonoscopy within the National Colorectal Cancer Screening Program in Poland, from January 1, 2004 through December 31, 2008...
April 17, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28419261/challenges-in-adapting-existing-clinical-natural-language-processing-systems-to-multiple-diverse-health-care-settings
#3
David S Carrell, Robert E Schoen, Daniel A Leffler, Michele Morris, Sherri Rose, Andrew Baer, Seth D Crockett, Rebecca A Gourevitch, Katie M Dean, Ateev Mehrotra
Objective: Widespread application of clinical natural language processing (NLP) systems requires taking existing NLP systems and adapting them to diverse and heterogeneous settings. We describe the challenges faced and lessons learned in adapting an existing NLP system for measuring colonoscopy quality. Materials and Methods: Colonoscopy and pathology reports from 4 settings during 2013-2015, varying by geographic location, practice type, compensation structure, and electronic health record...
April 17, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28410353/post-colonoscopy-colorectal-cancers-in-sweden-room-for-quality-improvement
#4
Anna Forsberg, Ulf Hammar, Anders Ekbom, Rolf Hultcrantz
OBJECTIVE: Post-colonoscopy colorectal cancer (PCCRC), a cancer occurring within a short interval of a colonoscopy, might be partly explained as missed or incompletely resected lesions. Associated risk factors are age, sex, comorbidity, cancer location, and colonoscopy volume. There is a gap in the knowledge of prevalence of PCCRC and the impact of different risk factors in Sweden. METHODS: This is a retrospective population-based observational cohort study of the colonoscopies performed on adults during the years 2001-2010 that were identified from Swedish health registers...
April 13, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28408995/multiple-zonal-and-multi-zone-adenoma-detection-rates-according-to-quality-of-cleansing-during-colonoscopy
#5
Stefano Pontone, Cesare Hassan, Roberta Maselli, Paolo Pontone, Rita Angelini, Manuela Brighi, Gregorio Patrizi, Daniele Pironi, Fabio Massimo Magliocca, Angelo Filippini
BACKGROUND: The safety and diagnostic accuracy of colonoscopy depend on the quality of colon cleansing. The adenoma detection rate is usually used as a quality measurement score. OBJECTIVE: We aimed to introduce and evaluate three new parameters to determine polyps and adenomas segmental localization and their distribution in association with different bowel preparation levels during colonoscopy. We introduce the multiple adenoma detection rate (the percentage of patients with >2 adenomas diagnosed during colonoscopy), the zonal adenoma detection rate (the percentage of patients with >2 adenomas diagnosed during colonoscopy in different colon areas (rectum, sigmoid, descending, transverse, ascending and cecum colon)), and multi-zone adenoma detection rate (the percentage of patients with >2 adenomas diagnosed during colonoscopy in different colon areas with at least a segment between them with or without lesions (i...
December 2016: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28405332/association-between-diverticulosis-and-colonic-neoplastic-lesions-in-individuals-with-a-positive-faecal-immunochemical-test
#6
Sergio Morini, Lorenzo Ridola, Cesare Hassan, Roberto Lorenzetti, Roberto Boggi, Massimo Napoli, Silverio Tomao, Angelo Zullo
BACKGROUND: The association between diverticulosis and colonic neoplastic lesions has been suggested, but data in literature are conflicting. This study aimed to investigate such a relationship in patients participating in a colorectal cancer screening program who underwent high-quality colonoscopy. METHODS: Data from consecutive individuals 50-75 years of age with a positive faecal immunological test were considered. Diverticulosis was categorised as present or absent...
February 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28399611/adenoma-detection-with-blue-water-infusion-colonoscopy-a-randomized-trial
#7
Adriane Lesne, Olivier Rouquette, Sandrine Touzet, Fabien Petit-Laurent, Gwenaelle Tourlonias, Audrey Pasquion, Jérôme Rivory, Guillermo Aguero Garcete, Julien Scanzi, Sylvaine Chalumeau, Christine Chambon-Augoyard, Driffa Moussata, Florence Leger-Nguyen, Stéphane Degeorges, Marion Chauvenet, Thierry Fontanges, Sandrine Baubet, Philippe Brulet, Claire Billioud, Elsa Thimonier, Karine Stroeymeyt-Martin, Benjamin Hamel, Emmanuelle Graillot, Claire Cruiziat, Olivia Scalone, Marc O'Brien, Denis Péré-Vergé, Jean-Christophe Souquet, Jean-Marc Phelip, Laurent Poincloux, Stéphanie Poupon-Bourdy, Angélique Denis, Laurent Magaud, Thierry Ponchon, Mathieu Pioche
Background and aims Colonoscopy is currently the reference method to detect colorectal neoplasia, yet some adenomas remain undetected. The water infusion technique and dying with indigo carmine has shown interesting results for reducing this miss rate. The aim of this study was to compare the adenoma detection rate (adenoma and adenocarcinoma; ADR) and the mean number of adenomas per patient (MAP) for blue-water infusion colonoscopy (BWIC) versus standard colonoscopy. Methods We performed a multicenter, randomized controlled trial in eight units, including patients with a validated indication for colonoscopy (symptoms, familial or personal history, fecal occult blood test positive)...
April 11, 2017: Endoscopy
https://www.readbyqxmd.com/read/28393103/efficacy-and-safety-of-picoprep-tailored-dosing-compared-with-picoprep-day-before-dosing-for-colon-cleansing-a-multi-centric-randomised-study
#8
Ralf Kiesslich, Stefan Schubert, Michael Mross, Tobias Klugmann, Michael Klemt-Kropp, Imke Behnken, Gillaume Bonnaud, Eric Keulen, Marcel Groenen, Michael Blaker, Thierry Ponchon, Wilfred Landry, Meredin Stoltenberg
Background and study aims The success of any colonoscopy procedure depends upon the quality of bowel preparation. We evaluated the efficacy and safety of a new tailored dosing (TD) regimen compared with the approved PICOPREP day-before dosing regimen (DBD) in the European Union. Patient and methods Patients (≥ 18 years) undergoing colonoscopy were randomised (2:1) to TD (Dose 1, 10 - 18 hours; Dose 2, 4 - 6 hours before colonoscopy) or DBD (Dose 1 before 8:00AM on the day before colonoscopy; Dose 2, 6 - 8 hours after Dose 1)...
April 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28392435/sex-specific-differences-in-colon-cancer-when-quality-measures-are-adhered-to-results-from-international-prospective-multicenter-clinical-trials
#9
Shrawan G Gaitonde, Aviram Nissan, Mladjan Protić, Alexander Stojadinovic, Zev A Wainberg, David C Chen, Anton J Bilchik
INTRODUCTION: There is no consensus on the relationship between patient sex and the location, stage and oncologic outcome of colon cancer (CC). We hypothesized a sex-specific difference in the biology and management of CC. STUDY DESIGN: Our cohort was drawn from a database of patients enrolled in international trials of nodal ultrastaging for non-metastatic CC. These trials required strict adherence to surgical and pathological quality measures. Postoperative follow-up included colonoscopy at 1 and 4 years and annual CT scans...
April 6, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28376974/impact-of-health-literacy-directed-colonoscopy-bowel-preparation-instruction-sheet
#10
Terry C Davis, Jill Hancock, James Morris, Perry Branim, Abhishek Seth, Alfred Rademaker, Connie L Arnold
OBJECTIVES: To improve patient colonoscopy bowel preparation with a newly developed simplified instruction sheet in a safety-net hospital system. METHODS: Bowel preparation quality was compared in a retrospective chart review of 543 patients, 287 of whom received standard instructions (9th grade reading level) between November 2015 and February 2016, and 256 of whom received simplified instructions (6th grade level) between March and May 2016. Instructions were mailed to all patients...
May 1, 2017: American Journal of Health Behavior
https://www.readbyqxmd.com/read/28344796/quality-of-colonoscopy-in-an-emerging-country-a-prospective-multicentre-study-in-russia
#11
Mariya Antipova, Mikhail Burdyukov, Mikhail Bykov, Leonid Domarev, Evgeny Fedorov, Sergey Gabriel, Konstantin Glebov, Sergey Kashin, Mikhail Knyazev, Aleksey Korotkevich, Andrey Kotovsky, Irina Kruglova, Vladimir Krushelnitsky, Ekaterina Mayat, Mikhail Merzlyakov, Dmitry Mtvralashvili, Aleksander Pyrkh, Oleg Sannikov, Evgeny Shitikov, Alexander Subbotin, Alexander Taran, Viktor Veselov, Dmitry Zavyalov, Cesare Hassan, Franco Radaelli, Lorenzo Ridola, Alessandro Repici, Mikhail Korolev
BACKGROUND: The quality of colonoscopy has been related to a higher risk of interval cancer, and this issue has been addressed extensively in developed countries. The aim of our study was to explore the main quality indicators of colonoscopy in a large emerging country. METHODS: Consecutive patients referred for colonoscopy in 14 centres were prospectively included between July and October 2014. Before colonoscopy, several clinical and demographic variables were collected...
March 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28344794/does-calprotectin-level-identify-a-subgroup-among-patients-suffering-from-irritable-bowel-syndrome-results-of-a-prospective-study
#12
Chloé Melchior, Moutaz Aziz, Typhaine Aubry, Guillaume Gourcerol, Muriel Quillard, Alberto Zalar, Moïse Coëffier, Pierre Dechelotte, Anne-Marie Leroi, Philippe Ducrotté
BACKGROUND: Irritable bowel syndrome is a multifactorial disease. Although faecal calprotectin has been shown to be a reliable marker of intestinal inflammation, its role in irritable bowel syndrome remains debated. OBJECTIVE: The aims of this prospective study were to select a subgroup of irritable bowel syndrome patients and to characterise those patients with high faecal calprotectin by systematic work-up. METHODS: Calprotectin levels were determined by enzyme-linked immunosorbent assay test in consecutive irritable bowel syndrome patients fulfilling Rome III criteria in whom normal colonoscopy and appropriate tests had excluded organic disease...
March 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28344793/correlation-between-adenoma-detection-rate-in-colonoscopy-and-fecal-immunochemical-testing-based-colorectal-cancer-screening-programs
#13
Joaquín Cubiella, Antoni Castells, Montserrat Andreu, Luis Bujanda, Fernando Carballo, Rodrigo Jover, Ángel Lanas, Juan Diego Morillas, Dolores Salas, Enrique Quintero
BACKGROUND: The adenoma detection rate (ADR) is the main quality indicator of colonoscopy. The ADR recommended in fecal immunochemical testing (FIT)-based colorectal cancer screening programs is unknown. METHODS: Using the COLONPREV (NCT00906997) study dataset, we performed a post-hoc analysis to determine if there was a correlation between the ADR in primary and work-up colonoscopy, and the equivalent figure to the minimal 20% ADR recommended. Colonoscopy was performed in 5722 individuals: 5059 as primary strategy and 663 after a positive FIT result (OC-Sensor™; cut-off level 15 µg/g of feces)...
March 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28328936/polyp-detection-rate-in-transverse-and-sigmoid-colon-significantly-increases-with-longer-withdrawal-time-during-screening-colonoscopy
#14
Kazuhiro Kashiwagi, Nagamu Inoue, Toshifumi Yoshida, Rieko Bessyo, Kazuaki Yoneno, Hiroyuki Imaeda, Haruhiko Ogata, Takanori Kanai, Yoshinori Sugino, Yasushi Iwao
BACKGROUND: The guidelines for colonoscopy present withdrawal time (WT) and adenoma detection rate (ADR) as the quality indicator. The purpose of this retrospective study is to analyze the predicting factors with polyp detection rate (PDR) as a surrogate for ADR by using comprehensive health checkup data, and assess the correlation between PDR per each colonic segment and WT, and factors influencing WT. METHODS: One thousand and thirty six consecutive health checkup cases from April 2015 to March 2016 were enrolled in this study, and 880 subjects who undertook colonoscopy without polyp removal or biopsy were divided into the two groups (polyp not detected group vs polyp detected group)...
2017: PloS One
https://www.readbyqxmd.com/read/28319429/current-standards-and-new-developments-of-colorectal-polyp-management-and-resection-techniques
#15
Daniel von Renteln, Mickael Bouin, Alan N Barkun
Colonoscopy and endoscopic removal of precancerous polyps play an important role in colorectal cancer (CRC) prevention. Improved endoscopes and quality standards have led to an increasing polyp and adenoma detection rate. Optimal polyp resection techniques and management strategies are key for an effective colonoscopy practice. Areas covered: Strategies for how to improve diminutive polyp (polyps up to 5mm in size) management are discussed because of their high prevalence. Systematic removal of diminutive polyps leads to increasing costs of colonoscopy practice, while the effect on colorectal cancer prevention might be negligible...
March 20, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28319242/quality-of-cancer-surveillance-clinical-practice-guidelines-specificity-and-consistency-of-recommendations
#16
Ryan P Merkow, Deborah Korenstein, Rubaya Yeahia, Peter B Bach, Shrujal S Baxi
Importance: Primary care clinicians, who are increasingly responsible for caring for the growing population of cancer survivors, may be unfamiliar with appropriate cancer surveillance strategies. Clinical practice guidelines can inform cancer follow-up care and surveillance testing. Vague recommendations and inconsistencies among guidelines can lead to overuse and underuse of health care resources and have a negative impact on cost and quality of survivorship care. Objective: To examine the specificity and consistency of recommendations for surveillance after active treatment across cancer guidelines...
March 20, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28303842/improvement-of-quality-of-nonanesthetic-colonoscopy-by-preoperative-administration-of-pinaverium-bromide
#17
Xiao-Lin Wang, Jian-Ning Zhou, Li Ren, Xiao-Li Pan, Hong-Yu Ren, Jun Liu
BACKGROUND: Nonanesthetic colonoscopy is popular in clinical practice in China. However, intestinal spasms often result in a prolonged examination time, increased operating difficulties, decreased polyp detection rate, and failure to complete the procedure clinically. Therefore, exploring alternative approaches that can reduce the pain in patients during colonoscopy is of utmost importance, and finding the optimal preoperative administration to improve the quality of nonanesthetic colonoscopy is also necessary...
March 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28296927/harms-benefits-and-costs-of-fecal-immunochemical-testing-versus-guaiac-fecal-occult-blood-testing-for-colorectal-cancer-screening
#18
S Lucas Goede, Linda Rabeneck, Marjolein van Ballegooijen, Ann G Zauber, Lawrence F Paszat, Jeffrey S Hoch, Jean H E Yong, Sonja Kroep, Jill Tinmouth, Iris Lansdorp-Vogelaar
BACKGROUND: The ColonCancerCheck screening program for colorectal cancer (CRC) in Ontario, Canada, is considering switching from biennial guaiac fecal occult blood test (gFOBT) screening between age 50-74 years to the more sensitive, but also less specific fecal immunochemical test (FIT). The aim of this study is to estimate whether the additional benefits of FIT screening compared to gFOBT outweigh the additional costs and harms. METHODS: We used microsimulation modeling to estimate quality adjusted life years (QALYs) gained and costs of gFOBT and FIT, compared to no screening, in a cohort of screening participants...
2017: PloS One
https://www.readbyqxmd.com/read/28293023/advances-in-image-enhancement-in-colonoscopy-for-detection-of-adenomas
#19
REVIEW
Takahisa Matsuda, Akiko Ono, Masau Sekiguchi, Takahiro Fujii, Yutaka Saito
High-quality colonoscopy is mandatory to prevent adenoma recurrence and colorectal cancer. In the past few years, technical advances have been developed with the purpose of improving adenoma detection rate (ADR), one of the most important validated colonoscopy quality benchmarks. Several techniques or devices are used to optimize visualization: observation techniques; add-on devices; auxiliary imaging devices; colonoscopes with increased field of view; and colonoscopes with an integrated inflatable reusable balloon...
March 15, 2017: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28262219/does-urgent-colonoscopy-improve-outcomes-in-the-management-of-lower-gastrointestinal-bleeding
#20
REVIEW
Ankur Seth, Muhammad Ali Khan, Richard Nollan, Deepansh Gupta, Sehrish Kamal, Utkarsh Singh, Faisal Kamal, Colin W Howden
Colonoscopy continues to be an essential diagnostic and therapeutic tool in the management of lower gastrointestinal bleeding (LGIB). Studies that have evaluated the role of urgent colonoscopy for treating LGIB have reached conflicting conclusions. We conducted a systematic review and meta-analysis to evaluate the role of urgent colonoscopy in several outcomes in patients with LGIB. We searched Medline, Embase, Scopus and Cochrane databases from inception to July 10, 2016 for comparative studies evaluating the role of urgent versus elective colonoscopy in the management of LGIB...
March 2017: American Journal of the Medical Sciences
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