Quality Assessment of Colonoscopy—Colonoscopic Miss Rates for Colon Cancer in the Private Practice Setting
Notice bibliographique
Résumé
Purpose: Data from the national polyp study indicates that surveillance colonoscopy with removal of adenomatous polyps reduces the incidence of colorectal cancer. Recent data from Canada indicates that 4% of patients with cancers located in the right colon had colonoscopy within 36 months of their diagnosis suggesting that these lesions may have been missed by colonoscopy. The aim of this study was to identify the rate of missed colon cancers in a large private practice to provide benchmark data for use in colonoscopy quality assessment programs. Methods: Medical records were reviewed from a 13 man single specialty private practice group located in Rockford, IL. All partners are board certified and have all performed a minimum of 2,000 colonoscopies. Cecal intubation rates exceed 98% for all participating colonoscopists. Patients who developed colon cancer between 2003 and 2004 were identified. Colonoscopy records were reviewed and patients who had a previous colonoscopy between 6 and 36 months were considered to have missed lesions. Colonoscopies performed within 6 months of the diagnosis were considered to be the index procedure. Additional data collected included patient demographics, location of cancer, number of previous colonoscopies, and family history of colon cancer. Results: During the period from 2003 to 2004, 16147 colonoscopies were performed. Colon cancer was identified in 206 patients for a rate of 1.3%. Of these 206, 10 (4.9%) had a colonoscopy between 6 and 36 months prior to their diagnosis suggesting that these lesions were missed. The mean age of these patients was 66.3 years with a range of 49 – 82 years; 8 were female and 2 males. 80% of the missed lesions were in the right colon and the other 20% in the rectosigmoid. Four of the six had a family history of colon cancer but none had a first degree relative. Conclusions: The rate of missed colon cancers in a large private practice group is similar to that observed in other studies suggesting that this rate is likely to be accurate. This data can be utilized to provide a starting point for determining benchmark rates to be used in future quality assessment of colonoscopy.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
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 | 0,004 | 0,024 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,002 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 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 ».