A238 COMPARISON OF ADENOMA DETECTION RATES IN COLONOSCOPIES PERFORMED IN-HOSPITAL VERSUS AN OUT OF HOSPITAL FACILITY IN A SINGLE PRACTICE
Bibliographic record
Abstract
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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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.011 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".