A207 POST-COLONOSCOPY COLORECTAL CANCERS IN ALBERTA: ROOM FOR QUALITY IMPROVEMENT
Bibliographic record
Abstract
Post-colonoscopy colorectal cancer (PCCRC) is an indicator of colonoscopy quality and can happen as a result of technical factors surrounding the procedure such as inadequate bowel preparation, incomplete examination, missed or partly resected early lesions and failure to adhere to follow-up guidelines. There is a gap in our knowledge of the prevalence and root causes of PCCRC in Alberta, which are essential for quality improvement interventions The aim of this study was to find out the prevalence and the factors associated with the development of PCCRC from a population based perspective. This study was carried out in Alberta, which has a population of 1.8 million people older than age 39. 100,000 colonoscopies are done in the province annually. Centralized population-based data is available through the Alberta Cancer Registry (ACR), National Ambulatory Care Reporting System (NACRS), Discharge Abstract Database (DAD), and the Alberta Ambulatory Care Reporting System (AACRS). All initial cases of CRC appearing in the ACR during 2013 were linked to the NACRS, DAD and AACRS databases to determine dates and characteristics of all antecedent colonoscopies. Health record of the retrieved cases were reviewed. The study authors according to a structured algorithm reviewed an abstract of each case. Cases were classified according to a set of predetermined root causes 1278 patients > 39 years of age were diagnosed with CRC in 2013 and had a colonoscopy identified by the database linkage. 146 CRC cases were diagnosed based on colonoscopy that was performed > 6 months but < 60 months after index colonoscopy. Cases were classified to root causes (See Table 1). A total of 71 colonoscopists had at least one missed cancer with one colonoscopist missed 5 cancers This study provides a rational basis for case exclusion as well as systematic categorization of PCCRC root causes. This approach can be used to obtain PCCRC data over longer periods of time and to get a more accurate estimate of its prevalence. The root causes identified in this study indicate that there is room for improvement in colonoscopy quality as well as for enhancement of clinical care pathways Table 1 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 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 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".