S290 Increase in Clinically Significant Serrated Polyp Rates Is Due to Higher Detection as Well as Interpretation by Pathologist

Abstract Background and study aims High-quality endoscopy requires improvement of not only the adenoma detection rate (ADR) but also the serrated polyp (SP) detection rate and the mean number of adenomas per positive procedure (MAP +). We evaluated whether a simple feedback of colonoscopy performance improves those quality indicators using propensity-score matching. Patients and methods Eleven endoscopists were evaluated regarding colonoscopy performance including ADRs, SP detection rates, mean numbers of adenomas per procedure (MAPs), and MAPs + with their ranking in the clinic. Endoscopic performance was compared before and after the feedback. Results Colonoscopies were performed for 874 patients before the feedback and 1,272 patients after the feedback. Using propensity-score matching, 803 patients before the feedback and 803 patients after the feedback were matched. ADR after the feedback was significantly higher than that before the feedback (50.8 % and 40.8 %, respectively). MAP after feedback was significantly larger than that before the feedback (0.92 and 0.69, respectively), as well as MAP + (1.96 and 1.69, respectively). Clinically significant SP detection rate was also improved from 10.0 % to 14.9 %. Conclusions Feedback including ADR, MAP, MAP +, and clinically significant SR detection rate could improve on those quality indicators. Further studies are needed to effectively prevent colorectal cancer in colonoscopy practice.

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S3119 Detection Rates of Adenoma, Clinically Significant Serrated Polyp, Proximal Serrated Polyp, and Laterally Spreading Tumors in Gastrointestinal Medicine (GI) Fellows

The American Journal of Gastroenterology ◽

10.14309/01.ajg.0000714524.82552.9b ◽

2020 ◽

Vol 115 (1) ◽

pp. S1641-S1642

Author(s):

Wenjing Cai ◽

Scott Diamond ◽

Mohamed Elmasry ◽

Khushboo Gala ◽

Amal Shine ◽

...

Keyword(s):

Detection Rates ◽

Gastrointestinal Medicine ◽

Serrated Polyp ◽

Clinically Significant ◽

Laterally Spreading Tumors

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Tu1034 – Proximal Serrated Polyp Detection Rate is a Surrogate Marker for Clinically Significant Serrated Polyps in Fellows

Gastroenterology ◽

10.1016/s0016-5085(19)39344-8 ◽

2019 ◽

Vol 156 (6) ◽

pp. S-955

Author(s):

Zain Moosvi ◽

Alexander Abadir ◽

Mohammed F. Ali ◽

William E. Karnes

Keyword(s):

Detection Rate ◽

Surrogate Marker ◽

Polyp Detection ◽

Serrated Polyps ◽

Serrated Polyp ◽

Polyp Detection Rate ◽

Clinically Significant

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EM of human atherosclerosis: Aortic fatty streaks with transitional lesion features

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100123519 ◽

1992 ◽

Vol 50 (1) ◽

pp. 622-623

Author(s):

K. Florian Klemp ◽

J.R. Guyton

Keyword(s):

Foam Cell ◽

Cell Formation ◽

Processing Technique ◽

Foam Cell Formation ◽

Tissue Preparation ◽

Electron Microscopic ◽

Extracellular Lipid ◽

Electron Microscopic Cytochemistry ◽

Human Atherosclerosis ◽

Clinically Significant

The earliest distinctive lesions in human atherosclerosis are fatty streaks (FS), characterized initially by lipid-laden foam cell formation. Fibrous plaques (FP), the clinically significant lesions, differ from FS in several respects. In addition to foam cells, the FP also exhibit fibromuscular proliferation and a necrotic core region rich in extracellular lipid. The possible transition of FS into mature FP has long been debated, however. A subset of FS described by Katz etal., was intermediate in lipid composition between ordinary FS and FP. We investigated this hypothesis by electron microscopic cytochemistry by employing a tissue processing technique previously described by our laboratory. Osmium-tannic acid-paraphenylenediamine (OTAP) tissue preparation enabled ultrastructural analysis of lipid deposits to discern features characteristic of mature fibrous plaques.

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Supervision: A Case Study

Language Speech and Hearing Services in Schools ◽

10.1044/0161-1461.0804.256 ◽

1977 ◽

Vol 8 (4) ◽

pp. 256-263

Author(s):

Roberta Chapey ◽

Geraldine Chapey

Keyword(s):

Organizational Communication ◽

Behavioral Changes ◽

Personal Problems ◽

Clinically Significant

Occasionally, it is the responsibility of a supervisor to help a staff speech clinician resolve professional and or personal problems that interfere with the delivery of quality services. To deal with this situation, the supervisor must be equipped with the techniques and procedures for effective organizational communication. This article presents a case study in which a speech clinician demonstrated irresponsibility in various job areas. The supervisor’s philosophy and the procedures used in managing these problems are presented. The behavioral changes suggest that the supervisor’s interventive procedures were clinically significant and warrant further investigation.

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Hearing Aid Gain Usage by Children

Language Speech and Hearing Services in Schools ◽

10.1044/0161-1461.2002.149 ◽

1989 ◽

Vol 20 (2) ◽

pp. 149-152 ◽

Cited By ~ 1

Author(s):

Kenneth W. Berger

Keyword(s):

Hearing Aid ◽

Appreciable Difference ◽

Significant Difference ◽

Clinically Significant

Hearing aid gain usage by two groups of children was examined. No appreciable difference was noted between the groups, nor was there a clinically significant difference between gain usage by these children as compared with a sample of adult hearing aid wearers.

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Tools & Resources: Impairment and Disability Web Sites

Guides Newsletter ◽

10.1001/amaguidesnewsletters.1999.novdec03 ◽

1999 ◽

Vol 4 (6) ◽

pp. 5-6

Keyword(s):

Personality Disorder ◽

Personality Disorders ◽

Interpersonal Relationships ◽

Web Sites ◽

Outpatient Psychotherapy ◽

Obsessive Compulsive ◽

Not Otherwise Specified ◽

Cluster B Personality Disorders ◽

Clinically Significant ◽

And Behavior

Abstract Personality disorders are enduring patterns of inner experience and behavior that deviate markedly from those expected by the individual's culture; these inflexible and pervasive patterns reflect issues with cognition, affectivity, interpersonal functioning and impulse control, and lead to clinically significant distress or impairment in social, occupational, or other important areas of functioning. The AMA Guides to the Evaluation of Permanent Impairment, Fourth Edition, defines two specific personality disorders, in addition to an eleventh condition, Personality Disorder Not Otherwise Specified. Cluster A personality disorders include paranoid, schizoid, and schizotypal personalities; of these, Paranoid Personality Disorder probably is most common in the legal arena. Cluster B personality disorders include antisocial, borderline, histrionic, and narcissistic personality. Such people may suffer from frantic efforts to avoid perceived abandonment, patterns of unstable and intense interpersonal relationships, an identity disturbance, and impulsivity. Legal issues that involve individuals with cluster B personality disorders often involve determination of causation of the person's problems, assessment of claims of harassment, and assessment of the person's fitness for employment. Cluster C personality disorders include avoidant, dependent, and obsessive-compulsive personality. Two case histories illustrate some of the complexities of assessing impairment in workers with personality disorders, including drug abuse, hospitalizations, and inpatient and outpatient psychotherapy.

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