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Chen J, Wang G, Zhou J, Zhang Z, Ding Y, Xia K, Xu X. AI support for colonoscopy quality control using CNN and transformer architectures. BMC Gastroenterol 2024; 24:257. [PMID: 39123140 PMCID: PMC11316311 DOI: 10.1186/s12876-024-03354-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 08/06/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND Construct deep learning models for colonoscopy quality control using different architectures and explore their decision-making mechanisms. METHODS A total of 4,189 colonoscopy images were collected from two medical centers, covering different levels of bowel cleanliness, the presence of polyps, and the cecum. Using these data, eight pre-trained models based on CNN and Transformer architectures underwent transfer learning and fine-tuning. The models' performance was evaluated using metrics such as AUC, Precision, and F1 score. Perceptual hash functions were employed to detect image changes, enabling real-time monitoring of colonoscopy withdrawal speed. Model interpretability was analyzed using techniques such as Grad-CAM and SHAP. Finally, the best-performing model was converted to ONNX format and deployed on device terminals. RESULTS The EfficientNetB2 model outperformed other architectures on the validation set, achieving an accuracy of 0.992. It surpassed models based on other CNN and Transformer architectures. The model's precision, recall, and F1 score were 0.991, 0.989, and 0.990, respectively. On the test set, the EfficientNetB2 model achieved an average AUC of 0.996, with a precision of 0.948 and a recall of 0.952. Interpretability analysis showed the specific image regions the model used for decision-making. The model was converted to ONNX format and deployed on device terminals, achieving an average inference speed of over 60 frames per second. CONCLUSIONS The AI-assisted quality system, based on the EfficientNetB2 model, integrates four key quality control indicators for colonoscopy. This integration enables medical institutions to comprehensively manage and enhance these indicators using a single model, showcasing promising potential for clinical applications.
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Affiliation(s)
- Jian Chen
- Department of Gastroenterology, Changshu Hospital Affiliated to Soochow University, Suzhou, 215500, China
| | - Ganhong Wang
- Department of Gastroenterology, Changshu Traditional Chinese Medicine Hospital (New District Hospital), Suzhou, 215500, China
| | - Jingjie Zhou
- Department of Gastroenterology, Changshu Hospital Affiliated to Soochow University, Suzhou, 215500, China
| | - Zihao Zhang
- Shanghai Haoxiong Education Technology Co., Ltd, Shanghai, 200434, China
| | - Yu Ding
- Department of Gastroenterology, Changshu Hospital Affiliated to Soochow University, Suzhou, 215500, China
| | - Kaijian Xia
- Department of Information Engineering, Changshu Hospital Affiliated to Soochow University, Suzhou, 215500, China.
| | - Xiaodan Xu
- Department of Gastroenterology, Changshu Hospital Affiliated to Soochow University, Suzhou, 215500, China.
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Rex DK, Ladabaum U, Anderson JC, Shaukat A, Butterly LF, Dominitz JA, Kaltenbach T, Levin TR, Hassan C. Does Screening Colonoscopy Have a Future in the United States? Clin Gastroenterol Hepatol 2023; 21:3005-3010. [PMID: 37536529 DOI: 10.1016/j.cgh.2023.05.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/23/2023] [Accepted: 05/26/2023] [Indexed: 08/05/2023]
Affiliation(s)
- Douglas K Rex
- Division of Gastroenterology/Hepatology, Indiana University School of Medicine, Indianapolis, Indiana.
| | - Uri Ladabaum
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California
| | - Joseph C Anderson
- Department of Veterans Affairs Medical Center, White River Junction, Vermont; Division of Gastroenterology and Hepatology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire; Division of Gastroenterology and Hepatology, University of Connecticut School of Medicine, Farmington, Connecticut
| | - Aasma Shaukat
- New York University Grossman School of Medicine, New York Harbor Veterans Affairs Medical Center, New York, New York
| | - Lynn F Butterly
- Division of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | - Jason A Dominitz
- National Gastroenterology and Hepatology Program, Veterans Health Administration, Washington, District of Columbia; Division of Gastroenterology, Department of Medicine, University of Washington School of Medicine, Seattle, Washington
| | - Tonya Kaltenbach
- Veterans Affairs San Francisco Healthcare System, San Francisco, California; Division of Gastroenterology, Department of Medicine, University of California San Francisco, San Francisco, California
| | | | - Cesare Hassan
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy; Endoscopy Unit, Humanitas Clinical and Research Center Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rozzano, Milan, Italy
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Sui Y, Zheng Y, Wang Q, Lv J, Wang H, Wen Q, Wang Z, Wang G, Jia H, Cao F, Wang N, Hao J, Zhang Y, Wu X, Chen H, Lu J, Chen X. Comparison of missed adenomas in deep-sedated and unsedated colonoscopy: A multicenter retrospective study. Eur J Intern Med 2023; 110:48-53. [PMID: 36710136 DOI: 10.1016/j.ejim.2023.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 01/17/2023] [Accepted: 01/23/2023] [Indexed: 01/29/2023]
Abstract
BACKGROUND Deep-sedated colonoscopy with propofol is widely used in China. However, its impact on quality metrics remains controversial. We aimed to investigate the effects of deep-sedated colonoscopy on missed adenomas, specifically in each colorectal segment. METHODS Data of 3710 individuals from seven hospitals in China who underwent an initial colonoscopy with or without propofol sedation and a second colonoscopy without sedation within six months for surveillance or polypectomy by endoscopist of the same level between October 2020 and September 2021 were retrospectively analyzed. RESULTS A total of 1113 missed adenomas in 3710 patients were evaluated. The adenoma miss rate (AMR) was significantly higher in deep-sedated colonoscopy than in unsedated colonoscop [19.14% (578/3020) vs. 16.15% (535/3313), P < 0.05]. The risk of missing adenomas in deep-sedated colonoscopy was 1.229 times higher than in unsedated colonoscopy (OR, 1.229; 95% CI: 1.080-1.399). AMRs of the splenic flexure (26.02% [96/369] vs. 16.04% [47/293], P < 0.05) and descending colon (20.86% [102/489] vs. 13.37% [54/404], P < 0.05) were significantly higher in deep-sedated colonoscopy than in unsedated colonoscopy when performed by middle-level endoscopists rather than high-level endoscopists (P < 0.05). CONCLUSIONS AMR was higher in deep-sedated colonoscopy than in unsedated colonoscopy. Furthermore, adenomas in the splenic flexure and descending colon were more frequently missed in deep-sedated colonoscopy than in unsedated colonoscopy, particularly when performed by less experienced endoscopists.
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Affiliation(s)
- Yue Sui
- Shanxi Medical University, 030000, China
| | | | - Qing Wang
- Shanxi Medical University, 030000, China.
| | - Jieping Lv
- The First Hospital of Shanxi Medical University, 03000, China.
| | - Hongjin Wang
- The Second People's Hospital of Datong, 037000, China
| | - Qing Wen
- The Second People's Hospital of Datong, 037000, China.
| | - Zhenzhen Wang
- The Second People's Hospital of Datong, 037000, China
| | - Guanfeng Wang
- The Second People's Hospital of Datong, 037000, China.
| | - Hui Jia
- Ordos Mongolian Medical Hospital, 017000, China.
| | - Fengzhen Cao
- Kangning Physical Examination Center, 017000, China
| | - Naping Wang
- The First Hospital of Shanxi Medical University, Yanhu District Branch, 044000, China
| | - Junlian Hao
- Xiaoyi Traditional Chinese Medicine Hospital, 033000, China.
| | - Yiping Zhang
- Datong Shoujia Digestive Disease Hospital, 037000, China.
| | - Xiaopeng Wu
- Lvliang Traditional Chinese Medicine Hospital, 033000, China.
| | - Haihua Chen
- The First Hospital of Shanxi Medical University, 03000, China.
| | - Junhui Lu
- Shanxi Medical University, 030000, China
| | - Xing Chen
- The First Hospital of Shanxi Medical University, 03000, China.
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Sedation Is Associated with Higher Polyp and Adenoma Detection Rates during Colonoscopy: A Retrospective Cohort Study. Gastroenterol Res Pract 2023; 2023:1172478. [PMID: 36852194 PMCID: PMC9966568 DOI: 10.1155/2023/1172478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 11/13/2022] [Accepted: 01/31/2023] [Indexed: 03/01/2023] Open
Abstract
Background and Aims Currently sedation is a common practice in colonoscopy to reduce pain of patients and improve the operator satisfaction, whereas its impact on examination quality, especially adenoma detection rate (ADR) is still controversial. Thus, we aimed to investigate the association of sedation with ADR. Methods Consecutive patients receiving colonoscopy between January 2017 and January 2020 at the Nanjing Drum Tower Hospital, Nanjing, China, were collected. Univariate and multivariate logistic regression models were performed to investigate the association between sedation and ADR. Subgroup analysis and propensity score matching (PSM) analysis, as sensitivity analysis, were performed to validate the independent effect. Results The ADR was significantly higher in cases with sedation (ADR: 36.9% vs. 29.1%, odds ratio [OR]: 1.42, 95% confidence interval [CI]: 1.31-1.55, P < 0.001). Multivariate analysis showed that the sedation was an independent factor associated with ADR (OR: 1.49, 95% CI: 1.35-1.65, P < 0.001). The effect was consistent in subgroup analyses (P > 0.05) and PSM analysis (ADR: 37.6% vs. 29.1%, OR: 1.47, 95% CI: 1.33-1.63, P < 0.001). Conclusion Sedation was associated with a higher polyp and ADR s during colonoscopy, which can promote the quality of colonoscopy.
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Groza AL, Ungureanu BS, Tefas C, Miuțescu B, Tanțău M. Correlation between adenoma detection rate and other quality indicators, and its variability depending on factors such as sedation or indication for colonoscopy. Front Pharmacol 2022; 13:1041915. [PMID: 36601057 PMCID: PMC9807161 DOI: 10.3389/fphar.2022.1041915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 12/08/2022] [Indexed: 12/23/2022] Open
Abstract
Colorectal cancer (CRC) is an important worldwide public health burden and colonoscopy is the main diagnostic and most importantly, preventive method. For this reason, many countries have implemented national or regional CRC screening programs. High-quality colonoscopy is a prerequisite to effectively detect premalignant lesions, like adenomas. The quality of colonoscopy is assessed using several quality indicators, the main one being adenoma detection rate (ADR). In Romania, despite CRC having the highest incidence of all cancers, there is no national screening program and quality in colonoscopy is not routinely assessed. We therefore wanted to evaluate the actual level of quality in colonoscopy in a region of Romania. Our study was conducted in two private endoscopy clinics over a period of 7 months. 1,440 consecutive colonoscopies performed by five physicians were included in the study. We found that the quality level is above the minimum one recommended by international societies and that the ADR calculation method does not significantly influence its value. Furthermore, ADR correlated well with other quality indicators such as polyp detection rate (PDR) and adenoma per colonoscopy (APC). An interesting finding was that ADR was higher among colonoscopies performed without sedation. Thus, our data encourage endoscopists to adopt a sedation-free colonoscopy in their practice without an impact on the quality of the procedure.
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Affiliation(s)
- Andrei Lucian Groza
- Iuliu Hațieganu University of Medicine and Pharmacy, 3rd Department of Internal Medicine, Cluj-Napoca, Romania,*Correspondence: Andrei Lucian Groza,
| | - Bogdan Silviu Ungureanu
- Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy of Craiova, Craiova, Romania,Department of Gastroenterology, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | - Cristian Tefas
- Iuliu Hațieganu University of Medicine and Pharmacy, 3rd Department of Internal Medicine, Cluj-Napoca, Romania,Regional Institute of Gastroenterology and Hepatology “Prof. dr. Octavian Fodor”, Cluj-Napoca, Romania
| | - Bogdan Miuțescu
- Department of Gastroenterology and Hepatology, “Victor Babeș" University of Medicine and Pharmacy, Timisoara, Romania
| | - Marcel Tanțău
- Iuliu Hațieganu University of Medicine and Pharmacy, 3rd Department of Internal Medicine, Cluj-Napoca, Romania,Regional Institute of Gastroenterology and Hepatology “Prof. dr. Octavian Fodor”, Cluj-Napoca, Romania
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Reduced Adenoma Miss Rate With 9-Minute vs 6-Minute Withdrawal Times for Screening Colonoscopy: A Multicenter Randomized Tandem Trial. Am J Gastroenterol 2022; 118:802-811. [PMID: 36219172 PMCID: PMC10144327 DOI: 10.14309/ajg.0000000000002055] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 09/02/2022] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Although the 9-minute mean withdrawal time (m-WT) is often reported to be associated with the optimal adenoma detection rate (ADR), no randomized trials of screening colonoscopy have confirmed the impact of a 9-minute m-WT on adenoma miss rate (AMR) and ADR. METHODS A multicenter tandem trial was conducted in 11 centers. Seven hundred thirty-three asymptomatic participants were randomized to receive segmental tandem screening colonoscopy with a 9-minute withdrawal, followed by a 6-minute withdrawal (9-minute-first group, 9MF, n = 366) or vice versa (6-minute-first group, 6MF, n = 367). The primary outcome was the lesion-level AMR. RESULTS The intention-to-treat analysis revealed that 9MF significantly reduced the lesion-level (14.5% vs 36.6%, P < 0.001) and participant-level AMR (10.9% vs 25.9%, P < 0.001), advanced adenoma miss rate (AAMR, 5.3% vs 46.9%, P = 0.002), multiple adenomas miss rate (20.7% vs 56.5%, P = 0.01), and high-risk adenomas miss rate (14.6% vs 39.5%, P = 0.01) of 6MF without compromising detection efficiency ( P = 0.79). In addition, a lower false-negative rate for adenomas ( P = 0.002) and high-risk adenomas ( P < 0.05), and a lower rate of shortening surveillance schedule ( P < 0.001) were also found in 9MF, accompanying with an improved ADR in the 9-minute vs 6-minute m-WT (42.3% vs 33.5%, P = 0.02). The independent inverse association between m-WT and AMR remained significant even after adjusting ADR, and meanwhile, 9-minute m-WT was identified as an independent protector for AMR and AAMR. DISCUSSION In addition to increasing ADR, 9-minute m-WT also significantly reduces the AMR and AAMR of screening colonoscopy without compromising detection efficiency.
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Afify S, Tag-Adeen M, Abu-Elfatth A, Eid A, Nageh A, Alzamzamy A, El-Raey F, Basiony AN, Abdelghani M, Abdeltawab D, Ahmed RM, Nasr H, Alkady MN, Ibrahim W, Elshaarawy O, Amer H, Thoufeeq M, Alboraie M. Quality indicators for colonoscopy in Egypt: A prospective multicenter study. Arab J Gastroenterol 2022; 23:253-258. [PMID: 35934640 DOI: 10.1016/j.ajg.2022.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 12/18/2021] [Accepted: 06/15/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND STUDY AIMS Despite its wide availability, we do not have sufficient data aboutthe quality of colonoscopy in Egypt. In this study, we proposed 13 indicators to assess the quality of colonoscopy procedures in the included study centers aiming to attain a representative image of the quality of CS in Egypt. PATIENTS AND METHODS A multicenter prospective study was conducted between July and December 2020, which included all patients who underwent colonoscopy in the participating centers. The following were the proposed quality indicators: indications for colonoscopy, preprocedure clinical assessment, obtaining written informed consent, adequate colon preparation, sedation, cecal intubation rate (CIR), withdrawal time, adenoma detection rate (ADR), complication rate, photographic documentation, automated sterilization, regular infection control check, and well-equipped postprocedure recovery room. RESULT A total of 1,006 colonoscopy procedures were performed during the study duration in the included centers. Our analysis showed the following four indicators that were fulfilled in all centers: appropriate indications for colonoscopy, preprocedure assessment, written informed consent, and automated sterilization. However, photographic documentation and postprocedure follow-up room were fulfilled only in 57 %. Furthermore, 71 % of the centers performed regular infection control checks. Adequate colon preparation was achieved in 61 % of the procedures, 81 % of the procedures were performed under sedation, 95.4 % CIR, 11-min mean withdrawal time, 15 % ADR, and 0.1 % overall complication rate. Statistically significant factors affecting CIR were age > 40 years, high-definition endoscope, previous colon intervention, and rectal bleeding, whereas those affecting ADR were age > 40 years, the use of image enhancement, previous colon intervention, rectal bleeding, the use of water pump, and a withdrawal time of > 9 min. CONCLUSION Our study revealed the bright aspects of colonoscopy practice in Egypt, including high CIRs and low complication rates; conversely, ADR, bowel cleansing quality, and infection control measures should be improved.
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Affiliation(s)
- Shimaa Afify
- Department of Gastroenterology, National Hepatology and Tropical Medicine Research Institute, Cairo, Postal Code: 11796 Cairo, Egypt
| | - Mohammed Tag-Adeen
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Qena Faculty of Medicine, South Valley University, Qena, Postal Code: 83523 Qena, Egypt.
| | - Ahmed Abu-Elfatth
- Department of Tropical Medicine and Gastroenterology, Assuit University, Assiut, Postal Code: 71515 Assiut, Egypt
| | - Alshaimaa Eid
- Department of Hepatogastroenterology and Infectious Disease, Al-Azhar University, Cairo, Postal Code: 11615 Cairo, Egypt
| | - Ahmed Nageh
- Department of Gastroenterology and Endoscopy, Alexandria Hepatology, GIT and Fever Hospital, Alexandria, Postal Code: 21544 Alexandria, Egypt
| | - Ahmed Alzamzamy
- Department of Gastroenterology and Hepatology, Maadi Armed Forces Medical Complex, Military Medical Academy, Cairo, Postal Code: 11711 Cairo, Egypt
| | - Fathiya El-Raey
- Department of Hepatogastroenterology and Infectious diseases, Al-Azhar University, Damietta, Postal Code: 34711 Damietta, Egypt
| | - Ahmed N Basiony
- Department of Tropical Medicine, Ain Shams University, Cairo, Postal Code: 11566 Cairo, Egypt
| | - Mohamed Abdelghani
- Department of Tropical Medicine and Gastroenterology, Assuit University, Assiut, Postal Code: 71515 Assiut, Egypt
| | - Doaa Abdeltawab
- Department of Tropical Medicine and Gastroenterology, Assuit University, Assiut, Postal Code: 71515 Assiut, Egypt
| | - Rasha M Ahmed
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Assuit University, Assiut, Postal Code: 71515 Assiut, Egypt
| | - Hayam Nasr
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Assuit University, Assiut, Postal Code: 71515 Assiut, Egypt
| | - Mohamed N Alkady
- Division of Gastro-intestinal Endoscopy, Department of Internal Medicine, Kasr Alaini Faculty of Medicine, Cairo University, Giza, Postal Code: 12613 Giza, Egypt
| | - Wael Ibrahim
- Department of Gastroenterology and Hepatology, Nasser Institute for Research and Treatment, Cairo, Postal Code: 11796 Cairo, Egypt
| | - Omar Elshaarawy
- Department of Hepatology and Gastroenterology, National Liver Institute, Menoufia University, Menoufia, Postal Code: 13829 Menoufia, Egypt
| | - Hossam Amer
- Department of General Medicine, Suad Kafafy University Hospital, Misr University for Science and Technology, Cairo, Postal Code: 12566 Cairo, Egypt
| | - Mo Thoufeeq
- Department of Endoscopy, Sheffield Teaching Hospitals, University of Sheffield, Sheffield, Postal Code: S5 7AU Sheffield, United Kingdom
| | - Mohamed Alboraie
- Division of Gastroenterology and Hepatology, Department of Internal Medicine , Al-Azhar University, Cairo, Postal Code: 11615 Cairo, Egypt
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Liang M, Zhang X, Xu C, Cao J, Zhang Z. Anesthesia Assistance in Colonoscopy: Impact on Quality Indicators. Front Med (Lausanne) 2022; 9:872231. [PMID: 35911411 PMCID: PMC9326494 DOI: 10.3389/fmed.2022.872231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 06/07/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundAdenoma detection rate (ADR) and polyp detection rate (PDR) are both indicators for colonoscopy quality. Improving ADR or PDR is critical for reducing the incidence and mortality of colorectal cancer (CRC). Although several studies have focused on identifying the factors that may influence ADR or PDR, the evidence remains limited and inconclusive. We conducted a retrospective study to evaluate the effect of anesthesia assistance (AA) on ADR or PDR in patients undergoing colonoscopy screening and identify risk factors affecting ADR or PDR.MethodsWe reviewed electronic medical records of patients who underwent colonoscopy screening between May 2019 and August 2020. Patients were divided into two groups according to whether they received AA: patients in Group A underwent colonoscopy screening with AA, whereas patients in Group O underwent colonoscopy screening without AA. Propensity score matching (PSM) was utilized to account for differences in baseline characteristics. After, ADR and PDR were compared between the two groups. Binary logistic regression was employed to identify risk factors that affected ADR or PDR.ResultsOf 9432 patients who underwent colonoscopy examination during the study period, 7170 were included in the final analyses (Group A = 5756 and Group O = 1414). After PSM, 736 patients remained in each group for analyses. There was no significant difference between groups A and O (P > 0.05) in ADR or PDR. Binary logistic regression indicated that the endoscopic device version (Olympus HQ290), equipment image-based technique and number of images were independent risk factors that affected ADR, and the age (50–59 years and 60–69 years), gender (male), high-risk status, endoscopist seniority (senior endoscopist), equipment image-based technique and number of images were all independent risk factors that affected PDR.ConclusionsWe discovered that AA does not affect ADR or PDR. Despite improved patient satisfaction, using AA is unnecessary for improving colonoscopy quality. Endoscopists should consider all these factors as much as possible when performing colonoscopy screening.
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Affiliation(s)
- Min Liang
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, China
- Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application Technology, Xuzhou Medical University, Xuzhou, China
- Department of Anesthesiology, Liaocheng People's Hospital, Liaocheng, China
| | - Xinyan Zhang
- Department of Pathology, Liaocheng People's Hospital, Liaocheng, China
| | - Chunhong Xu
- Department of Gastroenterology, Liaocheng People's Hospital, Liaocheng, China
| | - Junli Cao
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, China
- Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application Technology, Xuzhou Medical University, Xuzhou, China
- NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, China
- Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Zongwang Zhang
- Department of Anesthesiology, Liaocheng People's Hospital, Liaocheng, China
- *Correspondence: Zongwang Zhang
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Zhu XJ, Yang L. Progress in understanding of factors related to colonoscopic adenoma detection rate. Shijie Huaren Xiaohua Zazhi 2021; 29:1304-1310. [DOI: 10.11569/wcjd.v29.i22.1304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Adenoma detection rate (ADR) is the proportion of average-risk patients undergoing screening colonoscopy in whom an adenoma is found, and it is an important quality indicator of colonoscopy. ADR is closely related to the risk of interval colorectal cancer. A deeply study of ADR is essential for endoscopists. In this paper, we review the progress in the understanding of factors related to ADR before, during, and after colonoscopy, as well as several issues worthy of attention.
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Affiliation(s)
- Xiao-Jia Zhu
- Department of Gastroenterology, Third People's Hospital of Jingdezhen, Jingdezhen 333000, Jiangxi Province, China
| | - Li Yang
- Department of Gastroenterology, Third People's Hospital of Jingdezhen, Jingdezhen 333000, Jiangxi Province, China
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