A238 COMPARISON OF ADENOMA DETECTION RATES IN COLONOSCOPIES PERFORMED IN-HOSPITAL VERSUS AN OUT OF HOSPITAL FACILITY IN A SINGLE PRACTICE
Notice bibliographique
Résumé
Colonoscopy is considered the gold standard for colorectal cancer screening. Adenoma detection rate is considered an important quality indicator for any endoscopists who perform colonoscopies in patients for the purpose of colon cancer screening. Endoscopists may have specialties in different areas of medicine, including gastroenterology, general surgery, and internal medicine. Depending on individual practice and setting, a significant proportion of colonoscopies may not be for colon cancer screening. In Ontario, a significant proportion of colonoscopies are performed in out of hospital setting, or “private” clinics. To date there has been very limited data on the quality of procedures performed in out of hospital clinics in Ontario compared to the in-hospital setting. To determine whether location of colonoscopy (in-hospital versus out of hospital facility) affects adenoma detection rate. In this retrospective study, we analyzed colonoscopy data from a single general community gastroenterologist, who performs colonoscopies in both hospital and out of hospital facilities in approximately equal volumes. For each setting, the Polyp Detection Rate (PDR) and Adenoma Detection Rate (ADR) were determined as a gross rate and “true” rate. Gross rate is based on total number of colonoscopies performed for all indications. The eligibility criteria for “true” rate included symptomatic patients over the age of 50, surveillance at appropriate interval based on guidelines, family history of colon cancer, and positive fecal occult blood test fitting screening criteria based on Cancer Care Ontario ColonCancerCheck program guidelines. While total volumes in each setting is similar (approximately 500 annually in each setting), qualifying cases for true screening cases were lower in hospital setting (234 versus 466), but patients in hospital tended to be older (63.65 years compared to 58.94 years). Patients undergoing colonoscopy in hospital were more likely female (52.14%) and primarily for symptomatic reasons (46.15%). Patients undergoing colonoscopy in out of hospital clinic were more likely male (53.65%), and primarily for surveillance purposes (43.8%). In these population of patients, we report PDR rates of 70.94% in hospital colonoscopies and 75.32% in out of hospital clinic colonoscopies. The corresponding ADR rate in hospital colonoscopies was 54.70% and in out of hospital clinic was 59.01%. While this is retrospective data that is not controlled for many variables, adenoma detection rate for colonoscopies in an out of hospital clinic appears to be at least comparable, if not superior, to in hospital colonoscopies. As such, the quality of colonoscopies, as measured by ADR, performed in an out of hospital facility are comparable to those performed in an in-hospital setting. None
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,011 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,002 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».