Abstract
ADENOMA DETECTION RATE AND POLYP DETECTION RATE AMONG GASTROENTEROLOGY FELLOWS AND CONSULTANTS IN A TERTIARY HOSPITAL IN THE PHILIPPINES: A CROSS-SECTIONAL STUDY
Jonathan J. Macatiag IV1, Bernadette Alexis Mariño MD1, A. Nico Nahar I. Pajes, MD2, Eric B. Yasay, MD2
1Department of Medicine, University of the Philippines – College of Medicine And Philippine General Hospital 2Department of Medicine, Division of Gastroenterology,
University of the Philippines – College of Medicine and Philippine General Hospital
Significance: Colorectal cancer (CRC) is the third most commonly diagnosed cancer and the fourth leading cause of cancer mortality worldwide. Colorectal adenomas are widely regarded as precursors of CRC, and its natural history presents an opportunity for early prevention and intervention. Implementing quality measures in colonoscopy, such as the Adenoma Detection Rate (ADR) is important to ensure the quality of colonoscopy. Cancer detection post colonoscopy has been shown to be linked to higher ADR among endoscopists. Therefore, measures to determine and improve ADR must be instituted. This study aimed to identify and estimate ADRs from computed Polyp Detection Rate (PDR), as well as compare the ADR, PDR and factors associated with ADR among Gastroenterology Fellows and Consultants.
Methodology: This was an analytical, cross-sectional study among 309 patients who underwent colonoscopy at the Central Endoscopy Unit of the Philippine General Hospital. Demographic data of fellows and consultants were obtained through an online form. Patient’s demographic data, colonoscopy details and histopathology results were accessed through the hospital’s electronic records. ADR, PDR and estimated ADR were computed. To evaluate the strength of the relationship between the estimated and actual ADR, Pearson’s correlation coefficient was used. Univariable and multivariable logistic regression models were performed to identify the factors of the ADR. P?
Results: The total computed ADR among consultants and fellows combined was 22%. There was a significant statistical difference between the ADR of consultants and fellows-in-training (31.6% vs 18.7%, p=0.0168). The total PDR was 58.3%. The weighted group average Adenoma to Polyp Detection Rate Quotient (APDRQ) was 0.3795 (0-66.67, SD 0.2). The computed Pearson’s correlation coefficient was 0.517 (95% CI, 0.067-0.792, p=0.028), which signifies a high degree of correlation. Factors noted to have significant association with ADR included endoscopist experience (p=0.020), number of colonoscopies (p=0.031) and patient tobacco use (p=0.014).
Conclusion: The overall ADR was at par with guidelines. There was a high degree of correlation between actual and computed ADR, however; more studies are needed to determine local APDRQ in the local setting. A prospective study with a larger sample size may provide a better perspective on the factors associated with ADR.
Keywords: Colonoscopy, Colonic Polyps, Adenoma Detection Rate
Important Dates to Remember
| JRRE Activities 2023-2024 |
Proposed Dates |
|---|---|
| Resumption of face-to-face Evidence-Based Medicine Workshop Venue to be announced once finalized. |
July 21, 2023 (Friday), 1-5pm |
| Monthly Critical Appraisal of Topics Conferences to be gaciliated by Research Coordinators per Institution | Monthly Critical Appraisal of Topics Conferences per Institution |
| CAT Plenary/Liver Con Dates: September 23, 2023 December 16, 2023 March 2024 (During the JAC) Resumption of face-to-face Quarterly Critical Appraisal of Topics facilitated by the JRRE |
2 Clinical scenarios and articles are to be sent to institutions each on August 2023, November 2023, and February 2024; |
| Hybrid Research Workshop 4 week asynchronous via Moodle, followed by a 1 day on-site Onsite Workshop Research Protocol Presentation for Level I GI Fellows-In-Training - Research Protocol Presentation: August 12, 2023 - Research Forums of the Tripartite Societies |
Week 1: July 15-21, 2023 Week 2: July 22-28, 2023 Week 3: July 29-August 4, 2023 Week 4: August 5-11, 2023 |
| Research Manuscript Workshop for level II GI Fellows-In-Training | January 6, 2024 |