Gaze patterns hold key to unlocking successful search strategies and increasing polyp detection rate in colonoscopy

Abstract Background The adenoma detection rate (ADR) is an important quality indicator in colonoscopy. The aim of this study was to evaluate the changes in visual gaze patterns (VGPs) with increasing polyp detection rate (PDR), a surrogate marker of ADR. Methods 18 endoscopists participated in the study. VGPs were measured using eye-tracking technology during the withdrawal phase of colonoscopy. VGPs were characterized using two analyses – screen and anatomy. Eye-tracking parameters were used to characterize performance, which was further substantiated using hidden Markov model (HMM) analysis. Results Subjects with higher PDRs spent more time viewing the outer ring of the 3 × 3 grid for both analyses (screen-based: r = 0.56, P = 0.02; anatomy: r = 0.62, P < 0.01). Fixation distribution to the “bottom U” of the screen in screen-based analysis was positively correlated with PDR (r = 0.62, P = 0.01). HMM demarcated the VGPs into three PDR groups. Conclusion This study defined distinct VGPs that are associated with expert behavior. These data may allow introduction of visual gaze training within structured training programs, and have implications for adoption in higher-level assessment.

Download Full-text

Polyp detection rate: does length matter?

Frontline Gastroenterology ◽

10.1136/flgastro-2017-100945 ◽

2018 ◽

Vol 10 (2) ◽

pp. 107-112 ◽

Cited By ~ 1

Author(s):

Jonathan P Segal ◽

Cynthia Kanagasundaram ◽

Philip Mills ◽

Paul Bassett ◽

Simon M Greenfield

Keyword(s):

Cancer Screening ◽

Detection Rate ◽

Surrogate Marker ◽

Bowel Cancer ◽

Polyp Detection ◽

Detection Rates ◽

Polyp Detection Rate ◽

Adenoma Detection ◽

Bowel Cancer Screening ◽

The Difference

IntroductionPolyp detection rate is a surrogate marker for adenoma detection rate and therefore a surrogate marker of quality colonoscopy. To our knowledge, this is the first study that compares distance from the monitor to the endoscopist on polyp detection rate.MethodsThis was a retrospective study comparing polyp detection rate across two different endoscopy room set-ups. All colonoscopies performed between December 2013 and November 2014 were retrieved. The difference in the room set-up was the distance from the endoscopist to the endoscopy monitor. Room A had a distance of 219 cm and Room B had 147 cm. We used two identical rooms, C and D, as a control arm with a distance of 190 cm between the endoscopist and the monitor.ResultsThere were significant differences in polyp detection rates between Room A and Room B in the bowel cancer screening lists. For these lists, the room with the closest distance from the endoscopist to the monitor (147 cm) had a statistically significant higher polyp detection rate than the room that had a further monitor to endoscopist distance of 219 cm (p<0.0006) and a trend towards a higher polyp detection rate compared with the room where the distance between the monitor and the endoscopist was 190 cm (p=0.08). This effect was not noticed across the service lists.ConclusionsThis study has suggested that the distance from the endoscopist to the monitor can affect polyp detection rate. It appears that for bowel cancer screening lists, the further the endoscopist from the monitor the lower their polyp detection rate.

Download Full-text

SP1.1.11Is polyp detection rate a suitable surrogate measure for adenoma detection rate in colonoscopy?

British Journal of Surgery ◽

10.1093/bjs/znab361.006 ◽

2021 ◽

Vol 108 (Supplement_7) ◽

Author(s):

Hannah Javanmard-Emamghissi ◽

Isabel Perry ◽

Rahul Deb ◽

Gillian Tierney

Keyword(s):

Detection Rate ◽

Surrogate Marker ◽

Adenoma Detection Rate ◽

Advisory Group ◽

Pathology Report ◽

Polyp Detection ◽

Inflammatory Polyp ◽

Polyp Detection Rate ◽

Adenoma Detection ◽

Surrogate Measure

Abstract Aims The Joint Advisory Group on GI Endoscopy (JAG) has set key quality indicators for colonoscopy, which includes an adenoma detection rate of a minimum of 15%. Given the difficulty in reporting adenoma detection rate, JAG have stated that polyp detection rate is accepted as a surrogate measure. Our aim was to assess whether polyp detection rate can be used as a substitute marker for adenoma detection, by examining the histology of samples taken as polyps to determine what proportion are truly adenomas. Methods The pathology department provided a registry of all histological samples taken from the colon or rectum during a one-year period April 2017 to April 2018. These samples were cross-referenced with the endoscopy report to assess which were identified as “polyps” by the performing endoscopist. The pathology report was then reviewed to determine what the histological conclusion was for each “polyp”. Results A total of 1601 colorectal histology samples were reviewed, taken by 32 different endoscopists. 451 of these were identified as polyps by the performing endoscopist. On histological review 153 (33.9%) were not adenomas of the colon or rectum. Common alternative histological diagnoses were hyperplastic polyp, inflammatory polyp and normal tissue. Rarer alternative histological diagnoses were melanosis coli, submucosal leiomyoma and endometriosis of the rectum. Conclusions Polyp detection rate which is used as a surrogate marker for adenoma detection rate is an inaccurate measure of colonoscopy quality.

Download Full-text