Numbers matter: How pediatric endoscopy quality varies with annual procedural volume
Bibliographic record
Abstract
OBJECTIVES: There is limited data linking pediatric endoscopist experience and procedural quality. We aimed to examine the associations of faculty physicians' years in practice and independent annual procedural volume (APV) with published quality indicators for pediatric endoscopy, including terminal ileal intubation rate (TIIR), cecal intubation rate (CIR), and total procedure time. METHODS: We extracted quality indicators, as defined by the Pediatric Endoscopy Quality Improvement Network (PEnQuIN), for ileocolonoscopies performed by faculty endoscopists at a pediatric tertiary-care academic institution from October 2021 to May 2024. Endoscopists were categorized by years' experience and APV. Quality indicators were compared across groups using Kruskal-Wallis analyses. Multivariate modeling was performed to identify variables predicting terminal ileal intubation and TIIR ≥ 85%. Proportional hazards modeling was performed to identify variables predicting shorter procedure duration for combined esophagogastroduodenoscopy and ileocolonoscopy procedures. RESULTS: Nine hundred and eighty-five ileocolonoscopies were performed independently by 20 faculty endoscopists, with varying years' experience (<5 years: N = 7; 5-10 years: N = 3; ≥10 years: N = 10), and a median (interquartile range) APV of 19 (14, 45). Most procedures (71.7%) were scored as demonstrating adequate bowel preparation. Overall TIIR and CIR were 86.3% and 91.6%, respectively. In multivariate modeling, APV ≥ 40 was identified as predictive for TIIR ≥ 85% (p < 0.01) while faculty years' experience (≥10 vs. <10 years) predicted shorter procedure duration (adjusted hazard ratio [confidence interval]: 1.40 [1.23, 1.59]). CONCLUSIONS: Our data showed a significant association between pediatric quality indicators and individual endoscopist APV and years of experience. Our findings also suggest that performing ≥40 ileocolonoscopies annually may help ensure high-quality endoscopic procedures in children.
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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 | 0.023 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
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".