S604 The Evolving Practice of Water-Aided Colonoscopy (WAC) – An International Survey of Colonoscopists
Notice bibliographique
Résumé
Introduction: A water-aided technique (water immersion, WI) as an adjunct to gas insufflation was described in 1984. Water was infused to aid insertion through colonic segments deformed by diverticulosis, and the infused water was removed during withdrawal. Water exchange (WE) was described in 2010. Water infusion without air was used to aid insertion, followed by almost simultaneous removal of the infused water to minimize distention and to provide salvage cleaning. Worldwide, >80 reports on water-aided colonoscopy (WAC) have been published by 2020, documenting a steady growth in WE usage. A modified Delphi consensus review on WAC (GIE 2021;93:1411) reported that WE produces less pain and higher adenoma detection rates (ADR) than WI; underwater resection (UWR) is feasible, and has been applied to routine and salvage polypectomy. Methods: IWATERS (International Water-Aided Technique for Endoscopy and Research Society) conducted a survey to assess the clinical practice of WAC. Factors that might affect uptake of WAC were explored: colonoscopist demographics and experience, practice settings, allocated procedure time, the learning medium, perceived ease of learning and learning preference. A survey link was e-mailed to 55 co-authors of the Delphi review and distributed to their colleagues and trainees. Results: One hundred responses were received (from 84 practicing clinicians, 16 trainees). Responses with >80% affirmative answers (Table 1a) included: use of WAC, unlearning old methods to learn WAC is easier than expected, learning WAC is easy, clinical practice is in constant flux, WAC provides gains for my practice, have time to implement WAC, promote WAC in my practice, positive outcomes WAC vs. gas (air or CO2), and no reservations using WAC. Learning WAC was predominantly through coaching by mentors or colleagues and in a lesser degree from reading, viewing videos or attending seminars. Table 1b shows that more use of WI in respondents with usual scheduled colonoscopy time ≤30 minutes (p=0.026); and more use of WE (p=0.043) in respondents with usual scheduled colonoscopy time >30 minutes Conclusion: After learning the methods from mentors or colleagues, the surveyed endoscopists implement WAC (WI or WE) in their practice for the perceived positive benefits WAC provides their patients, even at the expense of increased procedure time (10 min) for WE. Coaching appeared to be the most popular method to acquire WAC skills. Usual scheduled colonoscopy time >30 min favors the use of WE.Figure 1.: Demographics and survey responses.
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 distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 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 tête enseignante, 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 ».