Factors determining the quality of screening colonoscopy: A prospective study on adenoma detection rates, from12 134 examinations (Berlin colonoscopy project 3, BECOP-3)

Andreas Adler, Karl Wegscheider, David Lieberman, Alireza Aminalai, Jens Aschenbeck, Rolf Drossel, Michael Mayr, Michael Mroß, Mathias Scheel, Andreas Schröder, Katharina Gerber, Gabriela Stange, Stephanie Roll, Ulrich Gauger, Bertram Wiedenmann, Lutz Altenhofen, Thomas Rosch

Research output: Contribution to journalArticle

124 Scopus citations

Abstract

Background: Screening colonoscopy (SC) outcome quality is best determined by the adenoma detection rate (ADR). The substantial variability in the ADRs between endoscopists may reflect different skills, experience and/or equipment. Objective: To analyse the potential factors that may influence ADR variance, including case volume. Design: 12 134 consecutive SCs (mean age 64.5 years, 47% men) from 21 Berlin private-practice colonoscopists were prospectively studied during 18 months. The data were analysed using a two-level mixed linear model to adequately address the characteristics of patients and colonoscopists. The ADR was regressed after considering the following factors: sex, age, bowel cleanliness, NSAID intake, annual SC case volume, lifetime experience, instrument withdrawal times, instrument generations used, and the number of annual continuing medical education (CME) meetings attended by the physician. The case volume was also retrospectively analysed from the 2007 national SC registry data (312 903 colonoscopies and 1004 colonoscopists). Results: The patient factors that correlated with the ADR were sex, age (p<0.001) and low quality of bowel preparation (p=0.005). The factors that were related to the colonoscopists were the number of CME meetings attended (p=0.012) and instrument generation (p=0.001); these factors accounted for approximately 40% of the interphysician variability. Within a narrow range (6-11 min), the withdrawal time was not correlated with the ADR. Annual screening case volume did not correlate with the ADR, and this finding was confirmed by the German registry data. Conclusions: The outcome quality of screening colonoscopies is mainly influenced by individual colonoscopist factors (ie, CME activities) and instrument quality. Clinical trial registration number: Clinical Trial Gov Registration number: NCT00860665.

Original languageEnglish (US)
Pages (from-to)236-241
Number of pages6
JournalGut
Volume62
Issue number2
DOIs
StatePublished - Feb 1 2013

ASJC Scopus subject areas

  • Gastroenterology

Fingerprint Dive into the research topics of 'Factors determining the quality of screening colonoscopy: A prospective study on adenoma detection rates, from12 134 examinations (Berlin colonoscopy project 3, BECOP-3)'. Together they form a unique fingerprint.

  • Cite this

    Adler, A., Wegscheider, K., Lieberman, D., Aminalai, A., Aschenbeck, J., Drossel, R., Mayr, M., Mroß, M., Scheel, M., Schröder, A., Gerber, K., Stange, G., Roll, S., Gauger, U., Wiedenmann, B., Altenhofen, L., & Rosch, T. (2013). Factors determining the quality of screening colonoscopy: A prospective study on adenoma detection rates, from12 134 examinations (Berlin colonoscopy project 3, BECOP-3). Gut, 62(2), 236-241. https://doi.org/10.1136/gutjnl-2011-300167