Factors Affecting the Quality of Bowel Preparation Before Colonoscopy in Outpatient: A Prospective Observational Study

2021 ◽  
pp. 105477382110673
Author(s):  
Shi Jun-li ◽  
Wang Lei ◽  
Ying Chun-ying ◽  
Fu Xin-zi ◽  
Li Bing-qing
Keyword(s):  
Colorectal Cancer ◽  
Logistic Regression ◽  
Bowel Preparation ◽  
Detection Rate ◽  
Prospective Observational Study ◽  
Time Interval ◽  
High Quality ◽  
Factors Affecting ◽  
Adenoma Detection

Colonoscopy is an effective method for screening colorectal cancer and adenoma, but the adenoma detection rate depends on the quality of bowel preparation. Our study investigates the influencing factors of the quality of bowel preparation before colonoscopy in outpatients and the influence of the number of walking steps on the quality of bowel preparation. We prospectively collected the clinical data of 150 outpatients undergoing colonoscopy in our department in 2019. Ordinal logistic regression shows that the overweight, not drinking, the number of walking steps before colonoscopy, and the time interval between start PEG and colonoscopy (4–6 hours) were independent factors affecting bowel preparation quality. There was a curving relationship between the reciprocal of Ottawa score and the number of walking steps before colonoscopy, and the regression equation is 1/ Ottawa score = −0.198 + 0.062 × ln steps ( p = .035), a minimum of 5,270 walking steps before a colonoscopy is required for a high quality of bowel preparation.

scholarly journals Surveying ADR knowledge and practices among US gastroenterologists

2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Michael Peng ◽  
Douglas Rex, MD, MACG
Keyword(s):  
Bowel Preparation ◽  
Detection Rate ◽  
Online Survey ◽  
Screening Colonoscopy ◽  
Current Evidence ◽  
Serrated Polyps ◽  
The Past ◽  
Adenoma Detection ◽  
Age And Sex

Background:   The adenoma detection rate (ADR) is of primary importance to the quality of screening colonoscopy. An online survey was conducted to assess knowledge and practices on ADR.  Methods:  Paid questionnaire distributed by email. Eligible respondents were board certified gastroenterologists who perform >80 colonoscopies per month with 3 to 35 years after fellowship.  Results:  39% were unaware that ADR applies only to screening colonoscopies and 76% incorrectly answered that ADR includes sessile serrated polyps/adenomas.  51% of respondents incorrectly believe the threshold is set at 25% because 25% is a national ADR average. Many also believe the threshold depends on the patient population (current evidence suggests adjusting ADR for factors other than age and sex is unnecessary). 75% ranked ADR as highly important. 80% reported tracking ADR. A busy practice was the most common reason for not tracking ADR. Caps, chromoendoscopy, and good bowel preparation were viewed as valuable for improving ADR (this is true except for caps). HD colonoscopes and education were considered less valuable (although evidence suggests HD and education are associated with improved ADR). 57% reported not sharing ADR information with their patients, and 59% reported no patients in the past 6 months asking for their ADR. Conclusion:  The importance of ADR as a validated quality measure is well understood, but there are misconceptions among gastroenterologists regarding the definition and measurement of ADR and which methods are proven to increase ADR.  Patients are having very little impact on ADR measurement.

910 A Prospective Study Evaluating the Association Between Timing and Quality of Bowel Preparation for Colonoscopy and Adenoma Detection Rate

2012 ◽  
Vol 75 (4) ◽  
pp. AB170 ◽  
Author(s):  
Kidist Yimam ◽  
Edward W. Holt ◽  
Hanley Ma ◽  
Richard E. Shaw ◽  
Richard Sundberg ◽  
...  
Keyword(s):  
Prospective Study ◽  
Bowel Preparation ◽  
Detection Rate ◽  
Adenoma Detection Rate ◽  
Adenoma Detection ◽  
A Prospective Study

scholarly journals Colonoscopy Quality and Adherence to Postpolypectomy Surveillance Guidelines in an Underinsured Clinic System

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Jaison John ◽  
Abdul Al-Douri ◽  
Bretta Candelaria ◽  
Saurin Gandhi ◽  
Paul Guzik ◽  
...  
Keyword(s):  
Bowel Preparation ◽  
Detection Rate ◽  
Safety Net ◽  
Adenoma Detection Rate ◽  
Evidence Based ◽  
High Quality ◽  
Cecal Intubation ◽  
Withdrawal Time ◽  
Adenoma Detection ◽  
Colonoscopy Quality

Background. Delivery of high-quality colonoscopy and adherence to evidence-based surveillance guidelines is essential to a high-quality screening program, especially in safety net systems with limited resources. We sought to assess colonoscopy quality and ensure appropriate surveillance in a network of safety net practices. Methods. We identified age-eligible patients ages 50-75 within a Federally Qualified Health Center (FQHC) clinic system with evidence of colonoscopy in preceding 10 years. We performed chart reviews to assess key aspects of colonoscopy quality: bowel preparation quality, evidence of cecal intubation, cecal withdrawal time, and the adenoma detection rate. We then utilized established guidelines to assess and revise surveillance colonoscopy intervals, determine whether appropriate surveillance had taken place, and schedule overdue patients as appropriate. Results. Of 26,394 age-eligible patients, a total of 3,970 patients had evidence of prior colonoscopy and 1,709 charts were selected and reviewed. Mean age was 57, 54% identified as women and 51% identified as Hispanic. Of 1709 colonoscopies reviewed, 77% had data on bowel preparation, and of those, 85% had adequate preparation quality. Cecal intubation was documented in 89% of procedures. Adequate cecal withdrawal time was documented in 59% of those with documented cecal intubation. Overall adenoma detection rate was 42%. Initial surveillance interval was clearly stated in 72% ( n = 1238 ) of procedures. Of these, initial recommended intervals were too short in 24.5% ( n = 304 ) and too long in 3.6% ( n = 45 ). A total of 132 patients (10.7%) were overdue for appropriate surveillance and were referred for follow-up colonoscopy. Conclusions. Overall, the quality of screening colonoscopy was high, but reporting was incomplete. We found fair adherence to evidence-based surveillance guidelines, with significant opportunities to extend surveillance intervals and improve adherence to best practices.

scholarly journals The effect of quality of segmental bowel preparation on adenoma detection rate

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Rui Guo ◽  
Yong-Jun Wang ◽  
Mo Liu ◽  
Jun Ge ◽  
Ling-Ye Zhang ◽  
...  
Keyword(s):  
Bowel Preparation ◽  
Detection Rate ◽  
Adenoma Detection Rate ◽  
Adenoma Detection

scholarly journals Impact of Video Aid on Quality of Bowel Preparation Among Patients Undergoing Outpatient Screening Colonoscopy

2018 ◽  
Vol 11 ◽  
pp. 117955221880330
Author(s):  
Sanna Fatima ◽  
Deepanshu Jain ◽  
Christopher Hibbard
Keyword(s):  
Bowel Preparation ◽  
Detection Rate ◽  
Adenoma Detection Rate ◽  
Screening Colonoscopy ◽  
Advanced Adenoma ◽  
Control Group ◽  
P Value ◽  
Group I ◽  
Adenoma Detection

Aim: To investigate the effect of video aid on quality of bowel preparation. Study: A retrospective study was done on patients undergoing outpatient screening colonoscopy. All subjects received educational video prior to colonoscopy in addition to the standard counseling. Patient charts were reviewed to collect data regarding quality of bowel preparation (adequate or inadequate). The study population was stratified into four groups according to viewing status: Group I 0% (control group), Group II <50%, Group III >50% to <75%, and Group IV watched ⩾75% of the video. Results: A total of 338 patients with an average age of 59.1 years and 60.3% females were included in the final study cohort. Of the patients in Groups I, II, III, and IV, 94.3%, 90.9%, 100%, and 91.7%, respectively, had adequate preparation ( P value = .827). Adenoma detection rate (ADR) for Groups I, II, III, and IV was 28.8%, 50%, 50%, and 22.6%, respectively ( P value = .305). The mean cecal intubation time was 20.7, 16.4, 16.57, and 17 minutes for Groups I, II, III, and IV, respectively ( P value = .041). Conclusions: Video aid use for patients undergoing screening colonoscopy lacked a statistically significant impact on the quality of bowel preparation, ADR, and advanced adenoma detection rate when compared with standard practice.

scholarly journals Factors Affecting Technology Adoption of Geoisolator on Solar Saltworks in East Java Province

Agriekonomika ◽  
2020 ◽  
Vol 9 (1) ◽  
pp. 28-37
Author(s):  
Aminah Happy Moninthofa Ariyani ◽  
Harianto Harianto ◽  
Suharno Suharno ◽  
Yusman Syaukat
Keyword(s):  
Logistic Regression ◽  
Logistic Regression Model ◽  
Family Members ◽  
Farmer Participation ◽  
Land Area ◽  
High Quality ◽  
Factors Affecting ◽  
Extension Agent ◽  
Solar Saltworks

Large quantity and high-quality salt are demanded in Indonesia, yet the quality of salt produced by farmers is still low. Increasing salt quantity and quality is possibly done through the implementation of geoisolator technology. This study aimed to investigate factors affecting the decision of salt farmers to adopt geoisolator technology. The study was conducted at the salt production center in Madura Island. A survey on salt farmer was carried out during August-September 2018. A total of 190 respondents consisted of 131 salt farmers who adopted geoisolator technology and 59 traditional salt farmers were selected as a sample in this study. Factors affecting farmer decision to adopt geoisolator technology was analyzed using logit (logistic regression) model. The result of this study showed that the decision of salt farmer to adopt geoisolator technology was affected by the number of productive-age family members and the number of dependent family members, land area, farmer participation in the group, farmer participation in extension. Enhancement in the adoption of geoisolator technology needs synergy between extension agent and salt farmer group so that the mentoring process and knowledge transfer will be achieved.

scholarly journals Colorectal cancer screening program using FIT: quality of colonoscopy varies according to hospital type

2018 ◽  
Vol 06 (09) ◽  
pp. E1149-E1156 ◽  
Author(s):  
Isabel Portillo ◽  
Isabel Idigoras ◽  
Isabel Bilbao ◽  
Eunate Arana-Arri ◽  
María José Fernández-Landa ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Detection Rate ◽  
Screening Colonoscopy ◽  
Hospital Type ◽  
Cecal Intubation ◽  
Academic Hospitals ◽  
Adenoma Detection

Abstract Background and study aims To compare the quality of colonoscopy in a population-based coordinated program of colorectal cancer screening according to type of hospital (academic or non-academic). Patients and methods Consecutive patients undergoing colonoscopy after positive FIT (≥ 20 ug Hb/g feces) between January 2009 and September 2016 were prospectively included at five academic and seven non-academic public hospitals. Screening colonoscopy quality indicators considered were adenoma detection rate, cecal intubation rate, complications and bowel preparation quality. Results A total of 48,759 patients underwent colonoscopy, 34,616 (80 %) in academic hospitals and 14,143 in non-academic hospitals. Among these cases, 19,942 (37.1 %) advanced adenomas and 2,607 (5.3 %) colorectal cancers (CRCs) were detected, representing a total of 22,549 (46.2 %) cases of advanced neoplasia. The adenoma detection rate was 64 %, 63.1 % in academic hospitals and 66.4 % in non-academic hospitals (P < 0.001). Rates of advanced adenoma detection, cecal intubation and adequate colonic preparation were 45.8 %, 96.2 % and 88.3 %, respectively, and in all cases were lower (implying worse quality care) in academic hospitals (45.3 % vs 48.7 %; odds ratio [OR] 0.87, 95 % confidence interval [CI] 0.84 – 0.91; 95.9 % vs 97 %; OR 0.48, 95 % CI 0.38 – 0.69; and 86.4 % vs 93 %; OR 0.48, 95 % CI 0.45 – 0.5; respectively; P < 0.001 in all cases). In 13 patients, all in the academic hospital group, CRC was diagnosed after colonoscopy (0.26 cases × 1000 colonoscopies). Rates of CRC treated by endoscopy were similar in both types of hospital (30 %). The rate of severe complication was 1.2 % (602 patients), with no significant differences by hospital type: bleeding occurred in 1/147 colonoscopies and perforation in 1/329. One patient died within 30 days after screening colonoscopy. Conclusions The quality of colonoscopy was better in non-academic hospitals. The rate of detection of advanced neoplasia was higher in non-academic hospitals and correlated with the rate of post-colonoscopy CRC.

scholarly journals The Impact of Sedation on Adenoma Detection Rate and Cecal Intubation Rate in Colonoscopy

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Qiongmei Zhang ◽  
Zhiyu Dong ◽  
Yuanxi Jiang ◽  
Tingting Zhan ◽  
Junwen Wang ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Model ◽  
Detection Rate ◽  
Logistic Regression Model ◽  
Independent Factor ◽  
Intubation Rate ◽  
Cecal Intubation ◽  
Adenoma Detection ◽  
Cecal Intubation Rate

Purpose. To explore the effect of sedation on the quality of colonoscopy. Methods. The data collected from the Digestive Endoscopy Center of Shanghai Tongji Hospital from March 2012 to June 2019 were retrospectively analyzed. The rate of sedation and quality metrics of colonoscopy such as adenoma detection rate (ADR) and cecal intubation rate (CIR) were calculated. The logistic regression model was used to explore the relationship between sedation and quality metrics of colonoscopy. The interaction effects between experience of endoscopists and sedation on quality of colonoscopy was also investigated in subgroups stratified by total number of colonoscopies during career using the logistic regression model. Results. A total of 63,417 colonoscopies including 11,417 colonoscopies without sedation and 52,000 colonoscopies with sedation were enrolled in our study. The proportion of colonoscopy with sedation was 82.0%. The ADR and CIR were all significantly higher in cases with sedation compared with cases without sedation (ADR, 22.5% vs. 17.0%, p < 0.001 ; CIR, 94.7% vs. 91.2%, p < 0.001 ). Multivariate analysis showed that the sedation was an independent factor associated with adenoma detection ( OR = 1.448 , 95% CI: 1.372~1.529, p < 0.001 ) and cecal intubation ( OR = 1.560 , 95% CI: 1.446~1.683, p < 0.001 ). A total of 14 endoscopists with complete colonoscopy data in our database and corresponding 20,949 colonoscopies data were enrolled for further analysis. The logistic regression model yielded a similar result that sedation was an independent factor on adenoma detection and cecal intubation when the factor, experience of endoscopists, was also entered into the model as a confounder (adenoma detection, OR = 1.408 , 95% CI: 1.333~1.487, p < 0.001 ; cecal intubation, OR = 1.601 , 95% CI: 1.482-1.729, p < 0.001 ). Conclusion. Colonoscopy with sedation has a positive effect on ADR and CIR in all endoscopists with different experience of colonoscopy, which makes the quality of colonoscopy better.

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