A50 ALBERTA FAMILY PHYSICIAN ELECTRONIC ENDOSOCPY (AFPEE) STUDY RESULTS
Bibliographic record
Abstract
In Canada, gastroenterologists and general surgeons perform 97% of all colonoscopies. A number of Canadian Family Physicians currently performing colonoscopies and training Family Physicians in endoscopy may help alleviate endoscopic wait times. For Family Physicians to be considered a legitimate option in the provision of colonoscopies, current FP colonoscopists must meet colonoscopy quality benchmarks. To compare the quality of colonoscopies performed by Family Physicians in Alberta, Canada to standard benchmarks using an electronic data capturing tool. Physicians (and their teams) collected real time data on colonoscopies performed during a six-month study period and performed pathology reconcilliation. Data was captured electronically on IPADs TM using a colonosocpy specific tool developed by the study team and housed in REDCap.TM Primary outcomes include cecal intubation rates, proportion of patients 50 years and older (separated by gender) having first time colonoscopy with an adenoma, and immediate complication rates. All potential adverse events were independently and blindly adjudicated by two physicians not involved in the study. Nine Alberta Family Physician colonoscopists, who perform endoscopy in 11 rural sites, participated in the study. The study physicians performed a total of 1769 colonoscopies (on 1755 unique patients) in the study for a mean of 197 colonoscopies performed per physician. Overall, 1731/1769 [97.9%, 95% CI: 97.2, 98.6] of colonoscopies attempted had a successful cecal intubation and all physicians achieve a cecal intubation rate of >95%. The proportion of males and females ≥ 50 years old who had their first colonosopy performed with an adenoma or sessile serrated adenoma (SSA) was 67.4% (95% CI; 62.1, 72.7) and 51.1% (95% CI; 45.5, 56.7) respectively. Overall, there were 120 adenomas or SSAs per 100 colonoscopies performed. There were two post polypectomy bleeds and no perforations or serious adverse events related to consicous sedation. Alberta Family Physicians who participated in the Alberta Family Physician Electronic Endoscopy (AFPEE) study are meeting quality standards in colonoscopy performance. Training some Family Physicians in GI medicine and endoscopy may help alleviate endoscopic wait times and improve access for patients of rural origin. Ongoing data collection using a simple, electronic data collection system which spans endoscopy reporting platforms should be encouraged. Alberta Rural Physician Action Plan, Northern Alberta Family Medicine Fund
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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 | 0.003 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.005 | 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".