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Quality colonoscopy

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https://www.readbyqxmd.com/read/28812156/accredited-residents-perform-colonoscopy-to-the-same-high-standards-as-consultants
#1
Dedrick Kok Hong Chan, Reuben Kong Min Wong, Khay Guan Yeoh, Ker-Kan Tan
BACKGROUND: Endoscopy remains a critical component of General Surgery and Gastroenterology training. Whilst residents need to gain experience, the quality of endoscopy which patients receive cannot be compromised. We conducted this study to compare quality indicators between consultants and residents with regards to colonoscopy. METHODS: A review of colonoscopies from a prospectively collected database was performed from September 2011 to February 2016. Quality indicators such as caecum intubation rate, adenoma detection rate, adherence to a 6-min withdrawal rule, mean number of polyps detected per colonoscope, and complications were collected and compared between the two groups...
August 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28812147/can-polyp-detection-rate-be-used-prospectively-as-a-marker-of-adenoma-detection-rate
#2
Brent Murchie, Kanwarpreet Tandon, Shamiq Zackria, Steven D Wexner, Colin O'Rourke, Fernando J Castro
BACKGROUND: Adenoma detection rate (ADR) is a quality indicator for screening colonoscopy, but its calculation is time-consuming. Polyp detection rate (PDR) has been found to correlate with ADR; however, its use as a quality indicator has been criticized out of concern for endoscopists artificially inflating the PDR. We aim to evaluate whether active monitoring affects PDR. METHODS: In March 2015, 14 endoscopists were made aware that their personal PDRs would be tracked monthly as a quality improvement project...
August 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28803744/novel-1l-polyethylene-glycol-based-bowel-preparation-ner1006-for-overall-and-right-sided-colon-cleansing-a-randomized-controlled-phase-3-trial-versus-trisulfate
#3
Michael P DeMicco, Lucy B Clayton, Jeff Pilot, Michael S Epstein
BACKGROUND AND AIMS: NER1006 is the first 32 fluid ounce (1L) polyethylene glycol-based bowel preparation. This randomized, multicenter, colonoscopist/central reader-blinded Phase 3 non-inferiority trial assessed the efficacy, safety, and tolerability of NER1006 versus trisulfate for bowel cleansing. METHODS: Patients undergoing colonoscopy were randomized (1:1) to receive NER1006 or trisulfate, using evening/morning split-dosing administration. Blinded central readers used the validated Harefield Cleansing Scale (HCS) to evaluate 2 alternative primary endpoints: overall bowel cleansing success and high-quality cleansing of the ascending colon/cecum...
August 10, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28803452/colonoscopic-surveillance-quality-guidelines-and-effectiveness
#4
REVIEW
Timothy J Chittleborough, Joseph C Kong, Glen R Guerra, Robert Ramsay, Alexander G Heriot
Colonoscopic surveillance in patients with a personal or family history of colorectal carcinoma or colonic polyps represents a significant workload for endoscopy services. Effective colonoscopic surveillance relies on quality endoscopic examination and appropriate surveillance interval. This review will discuss quality in colonoscopy and review guidelines for surveillance.
August 13, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28800046/quality-indicators-for-screening-colonoscopies-and-colonoscopist-performance-and-the-subsequent-risk-of-interval-bowel-cancer-a-systematic-review-protocol
#5
Martin Lund, Mette Trads, Rune Erichsen, Berit Andersen
The objective of this systematic review is to assess the association between quality indicators related to the individual colonoscopist's performance and subsequent interval cancers in patients participating in bowel cancer screening programs, following the JBI approach.This systematic review of association will search all relevant literature on the subject to answer the following review questions.
August 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28799068/colorectal-cancer-screening-in-asia
#6
REVIEW
Han-Mo Chiu, Wen-Feng Hsu, Li-Chun Chang, Ming-Hsiang Wu
PURPOSE OF REVIEW: Colorectal cancer (CRC) is increasing in Asia, especially in regions with higher levels of economic development. Several Asian countries have launched population CRC screening programs to combat this devastating disease because previous studies have demonstrated that either fecal occult blood test or lower gastrointestinal endoscopy can effectively reduce CRC mortality. RECENT FINDINGS: Screening includes engaging the population, testing, administering a confirmation examination, and treating screening-detected neoplasms; thus, monitoring the whole process using measurable indicators over time is of utmost importance...
August 10, 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28783920/training-in-endoscopy-colonoscopy
#7
REVIEW
Hyun Joo Jang
Colonoscopy is effective in reducing the morbidity and mortality associated with colorectal cancer (CRC). Interval cancers or post-colonoscopy CRCs, are cancers detected within the surveillance interval, or between 6-36 months after a clearing colonoscopy. The incidence of interval cancers is 3.4%-9.2% of all detected CRCs, as reported in population-based studies. Colonoscopy is a technically difficult procedure that is challenging to learn, and needs time and effort to gain competency. Therefore, trainee competence is a critical component of CRC screening and surveillance...
July 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28761869/correlation-between-bowel-preparation-and-the-adenoma-detection-rate-in-screening-colonoscopy
#8
Jung Hun Park, Sang Jin Kim, Jong Hee Hyun, Kyung Su Han, Byung Chang Kim, Chang Won Hong, Sang-Jeon Lee, Dae Kyung Sohn
PURPOSE: The adenoma detection rate is commonly used as a measure of the quality of colonoscopy. This study assessed both the association between the adenoma detection rate and the quality of bowel preparation and the risk factors associated with the adenoma detection rate in screening colonoscopy. METHODS: This retrospective analysis involved 1,079 individuals who underwent screening colonoscopy at the National Cancer Center between December 2012 and April 2014...
June 2017: Annals of Coloproctology
https://www.readbyqxmd.com/read/28761865/limitation-and-value-of-using-the-adenoma-detection-rate-for-colonoscopy-quality-assurance
#9
EDITORIAL
Jun Hur, Moo-Jun Baek
No abstract text is available yet for this article.
June 2017: Annals of Coloproctology
https://www.readbyqxmd.com/read/28759612/scheduling-rules-for-patients-with-diabetes-mellitus-that-facilitate-split-dosing-improve-the-quality-of-bowel-preparation-for-colonoscopy
#10
Robert J Hilsden, Ronald Bridges, Catherine Dube, Steven J Heitman, Alaa Rostom
BACKGROUND & AIMS: An adequate bowel preparation for colonoscopy is best achieved by giving the cleansing regimen as a split-dose with the second dose given 4-6 hours before the procedure. This can be difficult to administer to diabetics who are preferentially scheduled for early morning procedures. We examined the impact on bowel preparation quality of scheduling diabetics for mid-morning (9:30 am or later) procedures rather than early morning procedures (7:30-9:00 AM) to facilitate a split-dose preparation...
2017: PloS One
https://www.readbyqxmd.com/read/28753700/a-new-composite-measure-of-colonoscopy-the-performance-indicator-of-colonic-intubation-pici
#11
Roland M Valori, Sarah Damery, Daniel R Gavin, John T Anderson, Mark T Donnelly, J Graham Williams, Edwin T Swarbrick
Background and study aim Cecal intubation rate (CIR) is an established performance indicator of colonoscopy. In some patients, cecal intubation with acceptable tolerance is only achieved with additional sedation. This study proposes a composite Performance Indicator of Colonic Intubation (PICI), which combines CIR, comfort, and sedation. Methods Data from 20 085 colonoscopies reported in the 2011 UK national audit were analyzed. PICI was defined as the percentage of procedures achieving cecal intubation with median dose (2 mg) of midazolam or less, and nurse-assessed comfort score of 1 - 3/5...
July 28, 2017: Endoscopy
https://www.readbyqxmd.com/read/28753699/calculating-the-adenoma-detection-rate-in-screening-colonoscopies-only-is-it-necessary-can-it-be-gamed
#12
Douglas K Rex, Prasanna L Ponugoti
Background Current recommendations are to calculate the adenoma detection rate (ADR) in screening colonoscopies only. The need to confine the measure to screening has not been established. Methods We retrospectively assessed our quality database for whether calculating ADR from screening, surveillance, and diagnostic colonoscopies (overall ADR) would alter conclusions about the performance of colonoscopists, compared to using an ADR based only on screening colonoscopies. We also prospectively tested the extent to which one physician could corrupt the screening-only ADR by changing the procedure indication after reviewing the examination findings...
July 28, 2017: Endoscopy
https://www.readbyqxmd.com/read/28742732/educational-colonoscopy-video-enhances-bowel-preparation-quality-and-comprehension-in-an-inner-city-population
#13
Ajish Pillai, Radha Menon, David Oustecky, Asyia Ahmad
BACKGROUND: Quality of bowel preparation and patient knowledge remains a major barrier for completing colorectal cancer screening. Few studies have tested unique ways to impact patient understanding centering on interactive computer programs, pictures, and brochures. Two studies explored instructional videos but focused on patient compliance and anxiety as endpoints. Furthermore, excessive video length and content may limit their impact on a broad patient population. No study so far has studied a video's impact on preparation quality and patient understanding of the colonoscopy procedure...
July 24, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28727630/same-day-versus-split-dose-bowel-preparation-before-colonoscopy-a-meta-analysis
#14
Yuan-Lung Cheng, Kuang-Wei Huang, Wei-Chih Liao, Jiing-Chyuan Luo, Keng-Hsin Lan, Chien-Wei Su, Yuan-Jen Wang, Ming-Chih Hou
BACKGROUND: Split-dose regimens (SpDs) were recommended as a first choice for bowel preparation, whereas same-day regimens (SaDs) were recommended as an alternative; however, randomized trials compared them with mixed results. The meta-analysis was aimed at clarifying efficacy level between the 2 regimens. MATERIALS AND METHODS: We used MEDLINE/PubMed, EMBASE, Scopus, CINAHL, Cochrane Library, and Web of Science to identify randomized trials published from 1990 to 2016, comparing SaDs to SpDs in adults...
July 19, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28727629/an-automated-inpatient-split-dose-bowel-preparation-system-improves-colonoscopy-quality-and-reduces-repeat-procedures
#15
Rena Yadlapati, Elyse R Johnston, Adam B Gluskin, Dyanna L Gregory, Rachel Cyrus, Lindsay Werth, Jody D Ciolino, David P Grande, Rajesh N Keswani
BACKGROUND/GOALS: Inpatient colonoscopy preparations are often inadequate, compromising patient safety and procedure quality, while resulting in greater hospital costs. The aims of this study were to: (1) design and implement an electronic inpatient split-dose bowel preparation order set; (2) assess the intervention's impact upon preparation adequacy, repeated colonoscopies, hospital days, and costs. STUDY: We conducted a single center prospective pragmatic quasiexperimental study of hospitalized adults undergoing colonoscopy...
July 19, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28723744/association-between-bowel-habits-and-quality-of-bowel-preparation-for-colonoscopy
#16
Dong-Won Lee, Ja Seol Koo, Seonghee Kang, Seung Young Kim, Jong Jin Hyun, Sung Woo Jung, Hyung Joon Yim, Sang Woo Lee
The effectiveness of colonoscopy is highly dependent on the quality of bowel preparation. Although many studies have previously evaluated the role of cleansing methods and dosing regimens, few have examined the association between bowel habits and subsequent bowel preparation. Here, we aimed to evaluate the impact of bowel habits on the quality of bowel preparation.A total of 404 patients who underwent a total colonoscopy and completed a personal bowel habit questionnaire at Korea University Hospital between December 2012 and December 2013 were enrolled...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28710715/clinical-utility-of-a-blood-based-protein-assay-to-increase-screening-of-elevated-risk-patients-for-colorectal-cancer-in-the-primary-care-setting
#17
John Peabody, David Paculdo, Eric Swagel, Steven Fugaro, Mary Tran
PURPOSE: Colorectal cancer (CRC) screening is effective in finding early stage CRC and dramatically improves survival rates. Despite this, the number of eligible patients who do not obtain CRC screening is unacceptably high. METHODS: We conducted a longitudinal, randomized controlled trial investigating the utility of a blood-based protein assay on the quality of care delivered by practicing PCPs in the United States. We used standardized simulated patients (CPVs), presenting with symptoms suggestive of a higher likelihood of CRC, to measure how frequently these PCPs ordered diagnostic colonoscopy...
July 14, 2017: Journal of Cancer Research and Clinical Oncology
https://www.readbyqxmd.com/read/28706429/comparing-reduced-dose-sodium-phosphate-tablets-to-2-l-of-polyethylene-glycol-a-randomized-study
#18
Soichiro Ako, Koji Takemoto, Eriko Yasutomi, Chihiro Sakaguchi, Mayu Murakami, Tomoko Sunami, Shohei Oka, Hamada Kenta, Noriko Okazaki, Yuki Baba, Yasushi Yamasaki, Toshiyuki Asato, Daisuke Kawai, Ryuta Takenaka, Hirohumi Tsugeno, Sakiko Hiraoka, Jun Kato, Shigeatsu Fujiki
AIM: To compare the tolerability and quality of bowel cleansing between 2 L polyethylene glycol (PEG) and reduced-dose sodium phosphate (NaP) tablets as a preparation for colonoscopy. METHODS: Two hundred patients were randomly assigned to the PEG or NaP groups at the same ratio. The NaP group patients took 30 tablets with 2 L of clear liquid, while the PEG group patients took 2L of PEG. Tolerability was assessed by a questionnaire about taste, volume, and the overall impression...
June 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28706428/appropriateness-of-the-study-of-iron-deficiency-anemia-prior-to-referral-for-small-bowel-evaluation-at-a-tertiary-center
#19
Jaime Pereira Rodrigues, Rolando Pinho, Joana Silva, Ana Ponte, Mafalda Sousa, João Carlos Silva, João Carvalho
AIM: To evaluate the adequacy of the study of iron deficiency anemia (IDA) in real life practice prior to referral to a gastroenterology department for small bowel evaluation. METHODS: All consecutive patients referred to a gastroenterology department for small bowel investigation due to iron deficiency anemia, between January 2013 and December 2015 were included. Both patients referred from general practitioners or directly from different hospital departments were selected...
June 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28702775/quality-indicators-in-colonoscopy
#20
REVIEW
Kjetil Garborg, Thomas de Lange, Michael Bretthauer
Colonoscopy is one of the most commonly performed endoscopic procedures. It is the gold standard examination for work-up of colonic symptoms, for follow-up of positive colorectal cancer screening tests and for detection and removal of neoplastic polyps. Colonoscopy is a complex and invasive procedure with a potential not only for colorectal cancer prevention, but also for serious complications. Numerous factors may affect the balance of benefit versus harm of colonoscopy, including the performance of the endoscopist...
July 12, 2017: Current Treatment Options in Gastroenterology
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