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The impact of exclusion criteria on a physician's adenoma detection rate.
- Source :
-
Gastrointestinal endoscopy [Gastrointest Endosc] 2015 Oct; Vol. 82 (4), pp. 668-75. - Publication Year :
- 2015
-
Abstract
- Background: The adenoma detection rate (ADR) is a validated and widely used measure of colonoscopy quality. There is uncertainty in the published literature as to which colonoscopy examinations should be excluded when measuring a physician's ADR.<br />Objective: To examine the impact of varying the colonoscopy exclusion criteria on physician ADR.<br />Design: We applied different exclusion criteria used in 30 previous studies to a dataset of endoscopy and pathology reports. Under each exclusion criterion, we calculated physician ADR.<br />Setting: A private practice colonoscopy center affiliated with the University of Illinois College of Medicine.<br />Patients: Data on 20,040 colonoscopy examinations performed by 11 gastroenterologists from July 2009 to May 2013 and associated pathology notes.<br />Main Outcome Measurements: ADRs across all colonoscopy examinations, each physician's ADR, and ADR ranking.<br />Results: There were 28 different exclusion criteria used when measuring the ADR. Each study used a different combination of these exclusion criteria. The proportion of all colonoscopy examinations in the dataset excluded under these combinations of exclusion criteria ranged from 0% to 92.2%. The mean ADR across all colonoscopy examinations was 39.1%. The change in mean ADR after applying the 28 exclusion criteria ranged from -5.5 to +3.0 percentage points. However, the exclusion criteria affected each physician's ADR relatively equally, and therefore physicians' rankings via the ADR were stable.<br />Limitations: ADR assessment was limited to a single private endoscopy center.<br />Conclusion: There is wide variation in the exclusion criteria used when measuring the ADR. Although these exclusion criteria can affect overall ADRs, the relative rankings of physicians by ADR were stable. A consensus definition of which exclusion criteria are applied when measuring ADR is needed.<br /> (Copyright © 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Colonoscopy statistics & numerical data
Female
Gastroenterology statistics & numerical data
Humans
Male
Middle Aged
Young Adult
Adenoma diagnosis
Clinical Competence statistics & numerical data
Colonoscopy standards
Colorectal Neoplasms diagnosis
Gastroenterology standards
Patient Selection
Quality Indicators, Health Care statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1097-6779
- Volume :
- 82
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Gastrointestinal endoscopy
- Publication Type :
- Academic Journal
- Accession number :
- 26385275
- Full Text :
- https://doi.org/10.1016/j.gie.2014.12.056