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Evaluation of the polyp-based resect and discard strategy: a retrospective study
- Source :
- Endoscopy. 54:128-135
- Publication Year :
- 2021
- Publisher :
- Georg Thieme Verlag KG, 2021.
-
Abstract
- Background Standard colonoscopy practice requires removal and histological characterization of almost all detected small ( Methods A post hoc analysis was performed on patients enrolled in a prospective study. The primary outcome was surveillance interval agreement of the PBRD strategy with pathology-based management according to 2020 US Multi-Society Task Force guidelines. Chart analysis also evaluated clinician adherence to pathology-based recommendations. One-sided testing was performed with a null-hypothesis of 90 % agreement with pathology-based surveillance intervals and a two-sided 96.7 % confidence interval (CI) using correction for multiple testing. Results 452 patients were included in the study. Surveillance intervals assigned using the PBRD strategy were correct in 97.8 % (96.7 %CI 96.3–99.3 %) of patients compared with pathology-based management. The PBRD strategy reduced pathology examinations by 58.7 % while providing 87.8 % of patients with immediate surveillance interval recommendations on the day of colonoscopy, compared with 47.1 % when using pathology-based management. Chart analysis of surveillance interval assignments showed 63.3 % adherence to pathology-based guidelines. Conclusion The PBRD strategy surpassed the 90 % agreement with the pathology-based standard for determining surveillance interval, reduced the need for pathology examinations, and increased the proportion of patients receiving immediate surveillance interval recommendations. The PBRD strategy does not require expertise in optical diagnosis and may replace histological characterization of small and diminutive colorectal polyps.
- Subjects :
- medicine.medical_specialty
medicine.diagnostic_test
business.industry
General surgery
Gastroenterology
MEDLINE
Colonoscopy
Retrospective cohort study
Confidence interval
Clinical trial
03 medical and health sciences
0302 clinical medicine
Chart
030220 oncology & carcinogenesis
Post-hoc analysis
medicine
030211 gastroenterology & hepatology
Prospective cohort study
business
Subjects
Details
- ISSN :
- 14388812 and 0013726X
- Volume :
- 54
- Database :
- OpenAIRE
- Journal :
- Endoscopy
- Accession number :
- edsair.doi...........677692bf49e2cfe062d2869d359a4696