Association between Endoscopist Specialty and Colonoscopy Quality: Protocol for a Systematic Review and Meta-analysis
Abstract Background Colonoscopy is an important modality in the provision of colorectal cancer screening. Though effective and safe, the performance of screening-related colonoscopy is variable in terms of its overall quality, with endoscopist-related factors playing an important role in this variation. The purpose of this study is to systematically review the association between endoscopist specialty and colonoscopy quality and outcomes. Methods A comprehensive electronic search will be carried out to determine the association between endoscopist specialty and colonoscopy quality metrics and/or outcomes in adult patients undergoing colonoscopy. Two abstracters will independently determine study eligibility, assess study quality, and abstract study data. The primary outcome will be the adenoma detection rate (ADR); secondary outcomes will include cecal intubation rate (CIR), withdrawal time (WT), adverse events (AEs) and post-colonoscopy colorectal cancer (PCCRC). Rates of the above metrics and outcomes will also be compared between clinically relevant subgroups determined a priori. DerSimonian and Laird models will be used to perform meta-analyses for each outcome. Sources of heterogeneity will be explored via meta-regression analyses, if possible. Discussion Given the significant established variation in colonoscopy quality, endoscopist-related factors need to be explored. Our meta-analysis will address the important question of whether the specialty of the endoscopist impacts colonoscopy quality and/or outcomes. Systematic Review Registration PROSPERO CRD42021226251.