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Quality colonoscopy

Michael R Kolber, Shelley Ross
BACKGROUND AND OBJECTIVES: In Canada, few family physicians (FPs) perform endoscopy. Conflicting evidence exists on the quality of endoscopy performed by Canadian FPs, which may be explained by differing skillsets of these endoscopists. The objective of this study was to perform the first exploration of the practice, skills, and knowledge of Canadian FP endoscopists. METHODS: A cross-sectional survey, including direct knowledge test, was used. RESULTS: Twenty Canadian FP endoscopists completed the survey...
March 2018: Family Medicine
Way-Seah Lee, Chun-Wei Tee, Zhong-Lin Koay, Tat-Seng Wong, Fatimah Zahraq, Hee-Wei Foo, Sik-Yong Ong, Shin-Yee Wong, Ruey-Terng Ng
AIM: To study implications of measuring quality indicators on training and trainees' performance in pediatric colonoscopy in a low-volume training center. METHODS: We reviewed retrospectively the performance of pediatric colonoscopies in a training center in Malaysia over 5 years (January 2010-December 2015), benchmarked against five quality indicators: appropriateness of indications, bowel preparations, cecum and ileal examination rates, and complications. The European Society of Gastrointestinal Endoscopy guideline for pediatric endoscopy and North American Society for Pediatric Gastroenterology, Hepatology and Nutrition training guidelines were used as benchmarks...
March 7, 2018: World Journal of Gastroenterology: WJG
Simon J Craddock Lee, Stephen J Inrig, Bijal A Balasubramanian, Celette Sugg Skinner, Robin T Higashi, Katharine McCallister, Wendy Pechero Bishop, Noel O Santini, Jasmin A Tiro
The colorectal cancer (CRC) screening process involves multiple interfaces (communication exchanges and transfers of responsibility for specific actions) among primary care and gastroenterology providers, laboratory, and administrative staff. After a retrospective electronic health record (EHR) analysis discovered substantial clinic variation and low CRC screening prevalence overall in an urban, integrated safety-net system, we launched a qualitative analysis to identify potential quality improvement targets to enhance fecal immunochemical test (FIT) completion, the system's preferred screening modality...
March 2018: Preventive Medicine Reports
Rita Vale Rodrigues, Isabel Claro, Pedro Lage, Isadora Rosa, Sara Ferreira, João Pereira da Silva, António Dias Pereira
PURPOSE: Lynch syndrome (LS) is associated with a high risk of colorectal cancer (CRC). The aim of this study was to assess the cumulative risk for the development of colorectal adenomas or carcinomas in a LS CRC surveillance program and to audit the quality of the endoscopic procedures. METHODS: We evaluated 147 asymptomatic LS mutation carriers, without previous CRC, in a surveillance program with colonoscopy every 12-18 months, between 2005 and 2016. Data was obtained by retrospective review of colonoscopy reports and hospital clinical files...
March 9, 2018: International Journal of Colorectal Disease
Christopher D Mills, Chere McCamley, Michael P Swan
GOALS: To determine the effect of carbon dioxide insufflation on the most important outcome measure of colonoscopic quality: adenoma detection rate (ADR). BACKGROUND: Bowel cancer is the second most common cause of cancer deaths in males and females in Australia. Carbon dioxide has in recent times become the insufflation methodology of choice for screening colonoscopy for bowel cancer, as this has been shown to have significant advantages when compared with traditional air insufflation...
March 7, 2018: Journal of Clinical Gastroenterology
Gregory S Cooper, Sanford D Markowitz, Zhengyi Chen, Missy Tuck, Joseph E Willis, Barry M Berger, Dean E Brenner, Li Li
BACKGROUND: There is uncertainty as to the appropriate follow-up of patients who test positive on multimarker stool DNA (sDNA) testing and have a colonoscopy without neoplasia. AIMS: To determine the prevalence of missed colonic or occult upper gastrointestinal neoplasia in patients with an apparent false positive sDNA. METHODS: We prospectively identified 30 patients who tested positive with a commercially available sDNA followed by colonoscopy without neoplastic lesions...
March 7, 2018: Digestive Diseases and Sciences
Alida Andrealli, Silvia Paggi, Arnaldo Amato, Emanuele Rondonotti, Gianni Imperiali, Nicoletta Lenoci, Giovanna Mandelli, Natalia Terreni, Giancarlo Spinzi, Franco Radaelli
Background: A split-dose (SD) regimen is crucial for colonoscopy quality. Compliance with SD for early morning colonoscopy is generally poor. The present study evaluated whether pre-colonoscopy counselling, in addition to a dedicated leaflet, might increase SD uptake. Methods: Consecutive 50-69-year-old patients undergoing screening colonoscopy before 10 a.m. were randomized to either receive written information only on bowel preparation (Written Group, WG) or written and oral instructions (Written and Oral Group, WaOG)...
March 2018: United European Gastroenterology Journal
Miguel Areia, Manon Cw Spaander, Ernst J Kuipers, Mário Dinis-Ribeiro
Background: Endoscopic screening for gastric cancer is debatable in countries with an intermediate risk. Objective: The objective of this article is to determine the cost-utility of screening strategies for gastric cancer in a European country. Methods: We conducted a cost-utility analysis using a Markov model comparing three screening strategies versus no screening: stand-alone upper endoscopy, endoscopy combined with a colorectal cancer screening colonoscopy after a positive faecal occult blood test or pepsinogens serologic screening...
March 2018: United European Gastroenterology Journal
Roberto L Kaiser Junior, Luiz G de Quadros, Mikaell A G Faria, Fernanda S L Kaiser, Juan C O Campo, Idiberto J Zotarelli Filho
Background: Colonoscopy procedures are commonly performed and have high success rates. However, poor or inadequate bowel preparation is one of the most common reasons for a repeated or failed colonoscopy. We therefore performed an observational study followed by propensity score modeling to evaluate and compare the quality of bowel preparation with the use of Aquanet bowel cleansing devices (BCDs) versus the use of oral sodium picosulfate solution. Methods: We performed a prospective cross-sectional study to compare the quality of pre-endoscopic bowel preparation using a BCD with oral solution...
February 2018: Gastroenterology Research
Lara Hart, Humaira Nael, Natasha M Longmire, Mary Zachos
BACKGROUND: A well-visualized colon during colonoscopy has a direct impact on interpretation of findings and need for repeat procedure. Studies have been conducted in the adult population to assess factors contributing to improved bowel preparation. The primary aim of this study was to determine barriers and facilitators to good preparation in children. METHODS: A qualitative descriptive approach was utilized. Children age 2 to 18 years old, and their parents were recruited from the McMaster University Gastroenterology clinic from May 2015 to January 2016...
March 5, 2018: Journal of Pediatric Gastroenterology and Nutrition
Abimbola Adike, Matthew R Buras, Suryakanth R Gurudu, Jonathan A Leighton, Douglas O Faigel, Kevin C Ruff, Sarah B Umar, Francisco C Ramirez
Background: The impact of Boston bowel preparation scale (BBPS) scores on the adenoma detection rate (ADR) in each segment has not been adequately addressed. The aim of this study was to determine the association between segmental or overall ADR and serrated polyp detection rate (SDR) with segmental and total BBPS scores. Methods: All outpatient screening colonoscopies with documented BBPS scores were retrospectively reviewed at a tertiary institution from January to December 2013...
March 2018: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
Ira Roshan Afshar, Mo Seyed Sadr, Lisa L Strate, Myriam Martel, Charles Menard, Alan N Barkun
Objective: The use of early colonoscopy in the management of acute lower gastrointestinal bleeding (LGIB) is controversial, with disparate evidence. We aim to formally characterize the utility of early colonoscopy (within 24 h) in managing acute LGIB. Design: A systematic literature search to August 2016 identified fully published and abstracts of randomized controlled trials (RCTs) and observational studies assessing early colonoscopy in acute LGIB. Single-arm studies were also included to define incidence...
2018: Therapeutic Advances in Gastroenterology
Miriam P van der Meulen, Iris Lansdorp-Vogelaar, S Lucas Goede, Ernst J Kuipers, Evelien Dekker, Jaap Stoker, Marjolein van Ballegooijen
Purpose To compare the cost-effectiveness of computed tomographic (CT) colonography and colonoscopy screening by using data on unit costs and participation rates from a randomized controlled screening trial in a dedicated screening setting. Materials and Methods Observed participation rates and screening costs from the Colonoscopy or Colonography for Screening, or COCOS, trial were used in a microsimulation model to estimate costs and quality-adjusted life-years (QALYs) gained with colonoscopy and CT colonography screening...
February 27, 2018: Radiology
Kevin Selby, Gillian Bartlett-Esquilant, Jacques Cornuz
With their longitudinal patient relationships, primary care physicians and their care teams are uniquely situated to promote preventive medicine, including cancer screening. A confluence of forces is driving the demand for the personalization of cancer screening recommendations. Recommendations are increasingly based on individual patient preferences, medical history, genetic and environmental risk factors, and level of interaction with the healthcare system. Current examples include choices between colonoscopy, fecal testing, and emerging tests for colorectal cancer (CRC) screening; the use of genetic information and availability of home self-testing in cervical cancer screening; the integration of multiple risk factors and patient preferences to decide the intensity and length of breast cancer screening; and the issues of smoking cessation and competing priorities when deciding whether or not to pursue lung cancer screening...
2018: Public Health Reviews
(no author information available yet)
No abstract text is available yet for this article.
March 2018: Endoscopy
Anu E Obaro, Andrew A Plumb, Thomas R Fanshawe, Ulysses S Torres, Rachel Baldwin-Cleland, Stuart A Taylor, Steve Halligan, David N Burling
BACKGROUND: CT colonography is highly sensitive for colorectal cancer, but interval or post-imaging colorectal cancer rates (diagnosis of cancer after initial negative CT colonography) are unknown, as are their underlying causes. We did a systematic review and meta-analysis of post-CT colonography and post-imaging colorectal cancer rates and causes to address this gap in understanding. METHODS: We systematically searched MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials...
February 19, 2018: Lancet. Gastroenterology & Hepatology
Eugene Kligman, Wenfang Li, George J Eckert, Charles Kahi
BACKGROUND AND AIMS: The adenoma detection rate (ADR) is a powerful measure of screening colonoscopy quality. Patients who undergo colonoscopy for the evaluation of a positive fecal immunochemical test (FIT) have increased prevalence of colorectal neoplasia, but it is not known whether separate quality benchmarks are required. The aim of this study was to compare the conventional ADR to the ADR of colonoscopies performed for the evaluation of positive FIT, in asymptomatic average-risk patients...
February 22, 2018: Digestive Diseases and Sciences
Phuc Le, Van T Nghiem, Patricia Dolan Mullen, Abhishek Deshpande
BACKGROUND Clostridium difficile infection (CDI) presents a substantial economic burden and is associated with significant morbidity. While multiple treatment strategies have been evaluated, a cost-effective management strategy remains unclear. OBJECTIVE We conducted a systematic review to assess cost-effectiveness analyses of CDI treatment and to summarize key issues for clinicians and policy makers to consider. METHODS We searched PubMed and 5 other databases from inception to August 2016. These searches were not limited by study design or language of publication...
February 21, 2018: Infection Control and Hospital Epidemiology
Saeed Azizi, Hussein Al-Rubaye, Mohammed Adil Turki, Muhammad R Sameem Siddiqui, Arun P Shanmuganandan, Bushra Ehsanullah, Ranjeet Brar, Al-Mutaz Abulafi
BACKGROUND: Endoscopic examinations are a vital diagnostic tool for dysplasia. Establishing the precision of different modes of examination is essential due to the disparate pick-up rates of dysplasia. OBJECTIVE: The aim of this article was to establish the pick-up rates of dysplastic or cancerous lesions using white light endoscopy (WLE) and random/targeted biopsies, or chromoendoscopy (CE), in patients with ulcerative colitis (UC) without primary sclerosing (PSC) or Crohn's disease (CD)...
February 17, 2018: International Journal of Surgery
Amy L Lightner
Crohn's disease (CD) may affect any part of the gastrointestinal tract. When isolated to the colon, and patients become medically refractory, there are several surgical options - segmental resection, subtotal colectomy with ileorectal anastomosis, or a total proctocolectomy and end ileostomy. Unfortunately, surgery does not cure CD, and, regardless of the extent of bowel removed, recurrence may be seen in the small bowel. This may lead to need for further immunosuppression or surgery. Therefore, when appropriate, a segmental colectomy or subtotal colectomy may prevent a permanent ostomy required with a total proctocolectomy...
February 15, 2018: Inflammatory Bowel Diseases
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