A142 ENDOSCOPIST EDUCATIONAL INTERVENTIONS ARE ASSOCIATED WITH IMPROVEMENTS IN ADENOMA DETECTION RATE: A SYSTEMATIC REVIEW AND META-ANALYSIS
Notice bibliographique
Résumé
Abstract Background Screening-related colonoscopy reduces the overall morbidity and mortality associated with colorectal cancer. In order for screening-related colonoscopy to be effective and safe, endoscopists must be well trained. However, a significant degree of variation exists between endoscopists in terms of adenoma detection rate (ADR) and cecal intubation rate (CIR). ADR in particular is an important colonoscopy quality metric that has been directly and inversely related to the rate of post colonoscopy colorectal cancer (PCCRC). Educational interventions aimed at endoscopists have been developed in an attempt to optimize the performance of colonoscopy. It is unknown what benefit these have on colonoscopy quality indicators or outcomes, if any. Aims We performed a systematic review and meta-analysis to determine whether there is an association between educational interventions aimed at endoscopists and improvements in colonoscopy quality indicators or outcomes. Methods An electronic search was conducted through August 2019 for studies reporting on targeted endoscopist educational interventions and associations with ADR or other colonoscopy quality indicators, or outcomes. Interventions such as hands-on training modules, skills enhancement courses were included Pooled rate ratios (RR) and weighted mean differences (WMD) were calculated using DerSimonian and Laird random effects models. A priori subgroup and sensitivity analyses were performed to assess for potential methodological or clinical factors associated with any of the outcomes of interest. Results From 2,253 initial studies, 14 were included in the systematic review, and 8 were included in the meta-analysis for ADR, representing 76,373 colonoscopies. Educational interventions were associated with improvements in ADR (RR 1.28, 95% confidence intervals, CI, 1.19–1.38). Educational interventions were also associated with improvements in overall polyp detection rate, PDR (RR 1.17, 95% confidence intervals, CI, 1.02–1.35). Educational interventions were not associated with longer withdrawal times (WMD -0.03 minutes, 95% CI, -0.57 - 0.51) or improved CIR (RR 1.00, 95% CI, 0.99 to 1.02), though unadjusted CIR was high in both the pre- and post-intervention groups, at 94.5% and 95.0%, respectively. Figure 1 shows Forest plots comparing pre-intervention and post-intervention rates for A) ADR, b) PDR and c) CIR. Conclusions Our study provides evidence that educational interventions aimed at endoscopists significantly improve ADR and overall PDR. Educational interventions did not impact withdrawal time or cecal intubation rates, and thus, the specific mechanisms for their benefit remain incompletely clear. As part of quality improvement programs to optimize colonoscopy performance, educational interventions should be considered. Funding Agencies None
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 | 0,012 | 0,032 |
| Méta-épidémiologie (sens strict) | 0,003 | 0,002 |
| Méta-épidémiologie (sens large) | 0,018 | 0,049 |
| Bibliométrie | 0,007 | 0,007 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,003 | 0,002 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,003 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,006 | 0,001 |
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 ».