Endoscopy International Open最新文献_第8页

Technical outcomes between a drill dilator and ultra-tapered mechanical dilator during EUS-guided pancreaticogastrostomy: Comparative study.

IF 2.2

Endoscopy International Open Pub Date : 2025-01-07 eCollection Date: 2025-01-01 DOI: 10.1055/a-2487-3545

Takeshi Ogura, Saori Ueno, Atsushi Okuda, Nobu Nishioka, Jun Sakamoto, Jun Matsuno, Yuki Uba, Mitsuki Tomita, Nobuhiro Hattori, Junichi Nakamura, Kimi Bessho, Hiroki Nishikawa

{"title":"Technical outcomes between a drill dilator and ultra-tapered mechanical dilator during EUS-guided pancreaticogastrostomy: Comparative study.","authors":"Takeshi Ogura, Saori Ueno, Atsushi Okuda, Nobu Nishioka, Jun Sakamoto, Jun Matsuno, Yuki Uba, Mitsuki Tomita, Nobuhiro Hattori, Junichi Nakamura, Kimi Bessho, Hiroki Nishikawa","doi":"10.1055/a-2487-3545","DOIUrl":"10.1055/a-2487-3545","url":null,"abstract":"Background and study aims: Endoscopic ultrasound-guided pancreaticogastrostomy (EUS-PGS) is performed for patients who have failed ERCP. Tract dilation is one of the challenging procedural steps during EUS-PGS. Recently, a bougie dilator, the drill dilator, has become available. With this device, tract dilation can be easily performed without pushback of the echoendoscope, allowing stable scope positioning to be achieved during tract dilation. However, comparative studies between ultra-tapered mechanical and drill dilators have not been reported. The aim of this study was to compare the technical outcomes of these dilation devices.Patients and methods: Symptomatic patients with main pancreatic duct (MPD) strictures from January 2021 to November 2023 were included in this retrospective study. The technical success rate of tract dilation was first evaluated. Overall technical success rate, procedure time, and adverse events were evaluated as secondary outcomes.Results: The technical success rate of initial device insertion into the MPD was higher with the Tornus ES (100%, 12/12) compared with the ES dilator (60%, 9/15) ( P =0.013). Additional tract dilation rate to deploy the stent was needed in 86.7% (13/15) in the ES dilator group, and 8.3% (1/12) in the Tornus group ( P =0.001) and the overall technical success rate in the Tornus ES group was 100% (12/12). Mean procedure time was shorter in the Tornus ES group (13.38±3.80 min) compared with the ES dilator group (21.40±1.54 min) ( P =0.0013).Conclusions: In conclusion, Tornus ES might be considered as the initial dilation device during EUS-PGS.","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a24873545"},"PeriodicalIF":2.2,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Useful treatment selection strategy for endoscopic hemostasis in colonic diverticular bleeding according to endoscopic findings (with video).

IF 2.2

Endoscopy International Open Pub Date : 2025-01-07 eCollection Date: 2025-01-01 DOI: 10.1055/a-2471-1016

Takaaki Kishino, Yoko Kitamura, Takashi Okuda, Naoki Okamoto, Takayuki Sawa, Maiko Yamakawa, Kazuyuki Kanemasa

{"title":"Useful treatment selection strategy for endoscopic hemostasis in colonic diverticular bleeding according to endoscopic findings (with video).","authors":"Takaaki Kishino, Yoko Kitamura, Takashi Okuda, Naoki Okamoto, Takayuki Sawa, Maiko Yamakawa, Kazuyuki Kanemasa","doi":"10.1055/a-2471-1016","DOIUrl":"10.1055/a-2471-1016","url":null,"abstract":"Background and study aims: Direct or indirect clipping and endoscopic band ligation (EBL) are widely used for hemostasis in patients with colonic diverticular bleeding (CDB). However, no treatment selection strategy has been established. This report describes our approach and its outcomes.Patients and methods: We select direct clipping if the bleeding point is visible and clips could be inserted into the diverticulum. When direct clipping is not feasible, we select EBL as the second choice and indirect clipping as the third. We reviewed data from 192 patients treated with clipping or EBL for definitive CDB with stigmata of recent hemorrhage (SRH) at our hospital between March 2016 and February 2023.Results: The hemostatic method was clipping in 84 patients (direct, n=78; indirect, n=6) and EBL in 108. The rate of SRH with active bleeding was significantly higher in the EBL group (33.3% vs. 60.2%, p <0.001). Median hemostasis time was significantly shorter in the clipping group (9 min vs. 22 min, P <0.001). There was no significant difference in the 30-day rebleeding rate between clipping and EBL (15.5% vs. 13.0%; P =0.619). There was one case of delayed perforation post-EBL. There were no complications after clipping.Conclusions: Direct clipping when placement of clips at the bleeding point is feasible and EBL when direct clipping is not feasible is a reasonable strategy in terms of effectiveness, efficiency, and safety. Selection of hemostatic method according to the visual field of SRH and maneuverability of the endoscope allows the advantages of both methods to be realized.","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a24711016"},"PeriodicalIF":2.2,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Spinal anesthesia for endoscopic submucosal dissection of large rectosigmoid lesions: Feasibility study. 脊髓麻醉用于内镜下粘膜下解剖大直肠乙状结肠病变的可行性研究。

IF 2.2

Endoscopy International Open Pub Date : 2024-12-17 eCollection Date: 2024-12-01 DOI: 10.1055/a-2441-2543

Giuliano Francesco Bonura, Paolo Biancheri, Joachim Rainer, Paola Soriani, Enrique Rodriguez de Santiago, Arianna Parrella, Alice Campioli, Emmanuele Guerra, Eugenia Gualdi, Alessandro Pignatti, Mauro Manno

{"title":"Spinal anesthesia for endoscopic submucosal dissection of large rectosigmoid lesions: Feasibility study.","authors":"Giuliano Francesco Bonura, Paolo Biancheri, Joachim Rainer, Paola Soriani, Enrique Rodriguez de Santiago, Arianna Parrella, Alice Campioli, Emmanuele Guerra, Eugenia Gualdi, Alessandro Pignatti, Mauro Manno","doi":"10.1055/a-2441-2543","DOIUrl":"10.1055/a-2441-2543","url":null,"abstract":"Background and study aims Colorectal endoscopic submucosal dissection (ESD) is often challenging and time-consuming. Prolonged sedation and general anesthesia are associated with a relevant risk of anesthesia-related adverse events (ARAEs), especially in elderly and frail patients. Spinal anesthesia (SA), a simple technique providing analgesia and motor block without systemic drug administration, has never been described in gastrointestinal endoscopy. We assessed the feasibility of SA in colorectal lesion ESD. Patients and methods We retrospectively collected data on all consecutive patients who underwent ESD for colorectal laterally spreading tumors (LSTs) under SA in our center during the last 3 years. We evaluated the rates of technical success, i.e. ESD completion under SA without need of conversion to deep sedation or general anesthesia, and ARAEs after SA. Results ESD under SA was performed on 20 rectosigmoid LSTs ≥ 35 mm. Technical success was achieved in 95.0% of cases (19/20), while one patient (5.0%) required conversion to deep sedation. Two patients (10.0%) experienced acute urinary retention that was successfully treated with temporary catheterization. Conclusions Our initial experience suggests that SA for ESD of large rectosigmoid LSTs is feasible, and it may prove to be a valuable option, especially for elderly and frail patients.","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"12 12","pages":"E1447-E1452"},"PeriodicalIF":2.2,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11651919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Validity evidence for endoscopic ultrasound competency assessment tools: Systematic review. 内窥镜超声能力评估工具的有效性证据：系统回顾。

IF 2.2

Endoscopy International Open Pub Date : 2024-12-17 eCollection Date: 2024-12-01 DOI: 10.1055/a-2465-7283

Alessandra Ceccacci, Harneet Hothi, Rishad Khan, Nikko Gimpaya, Brian P H Chan, Nauzer Forbes, Paul James, Daniel Jeffry Low, Jeffrey Mosko, Elaine T Yeung, Catharine M Walsh, Samir C Grover

{"title":"Validity evidence for endoscopic ultrasound competency assessment tools: Systematic review.","authors":"Alessandra Ceccacci, Harneet Hothi, Rishad Khan, Nikko Gimpaya, Brian P H Chan, Nauzer Forbes, Paul James, Daniel Jeffry Low, Jeffrey Mosko, Elaine T Yeung, Catharine M Walsh, Samir C Grover","doi":"10.1055/a-2465-7283","DOIUrl":"10.1055/a-2465-7283","url":null,"abstract":"Background and study aims Competent endoscopic ultrasound (EUS) performance requires a combination of technical, cognitive, and non-technical skills. Direct observation assessment tools can be employed to enhance learning and ascertain clinical competence; however, there is a need to systematically evaluate validity evidence supporting their use. We aimed to evaluate the validity evidence of competency assessment tools for EUS and examine their educational utility. Methods We systematically searched five databases and gray literature for studies investigating EUS competency assessment tools from inception to May 2023. Data on validity evidence across five domains (content, response process, internal structure, relations to other variables, and consequences) were extracted and graded (maximum score 15). We evaluated educational utility using the Accreditation Council for Graduate Medical Education framework and methodological quality using the Medical Education Research Quality Instrument (MERSQI). Results From 2081 records, we identified five EUS assessment tools from 10 studies. All tools are formative assessments intended to guide learning, with four employed in clinical settings. Validity evidence scores ranged from 3 to 12. The EUS and ERCP Skills Assessment Tool (TEESAT), Global Assessment of Performance and Skills in EUS (GAPS-EUS), and the EUS Assessment Tool (EUSAT) had the strongest validity evidence with scores of 12, 10, and 10, respectively. Overall educational utility was high given ease of tool use. MERSQI scores ranged from 9.5 to 12 (maximum score 13.5). Conclusions The TEESAT, GAPS-EUS, and EUSAT demonstrate strong validity evidence for formative assessment of EUS and are easily implemented in educational settings to monitor progress and support learning.","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"12 12","pages":"E1465-E1475"},"PeriodicalIF":2.2,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11651920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Splenic injury associated with colonoscopy in hospitalized patients: Incidence, risk factors, management, and outcome. 与住院病人结肠镜检查相关的脾脏损伤：发病率、风险因素、处理和结果。

IF 2.2

Endoscopy International Open Pub Date : 2024-12-17 eCollection Date: 2024-12-01 DOI: 10.1055/a-2453-2350

Herbert Koop, Christoph Skupnik, Torsten Schnoor, Dirk Horenkamp-Sonntag

{"title":"Splenic injury associated with colonoscopy in hospitalized patients: Incidence, risk factors, management, and outcome.","authors":"Herbert Koop, Christoph Skupnik, Torsten Schnoor, Dirk Horenkamp-Sonntag","doi":"10.1055/a-2453-2350","DOIUrl":"10.1055/a-2453-2350","url":null,"abstract":"Background and study aims The frequency of splenic injuries due to coloscopy is largely unknown. Therefore, the aim of this study was to give estimate the risk for hospitalized patients. Patients and methods Using the administrative database from a health insurance company with more than 10 million insured subjects, patients undergoing inpatient colonoscopy associated with a splenic injury within 2 weeks were retrieved from the administrative records based upon OPS (comparable to International Classification of Procedures in Medicine) and ICD-10 codes. In each case identified (n = 141), the individual course of the hospital stay was reconstructed and analyzed by two experienced physicians. Patients with overt other causes of splenic injuries (e. g. abominal surgery, trauma etc.) were not further evaluated. Results Among 190,927 total colonoscopies over a 5-year period, 27 splenic lesions were most likely solely due to colonoscopy. This accounts for 14.1 splenic injuries per 100,000 colonoscopies or one lesion in 7,071 patients. Afflicted patients were older and more likely to be female than male (risk in females: 1 in 5,324 colonoscopies). Surgical interventions were carried out in 17 cases, predominantly splenectomy (n = 15) whereas 10 events were managed conservatively. Transfusions and requirement for intensive care unit treatment were strong predictors of need for surgery. Most lesions (74%) were diagnosed within 48 hours after colonoscopy. Death occurred in two patients, but less likely directly due to the splenic injury. Conclusions Administrative data analysis suggests that splenic injuries due to colonoscopy are more frequent than previously estimated. Endoscopists should be aware of this rare life-threatening adverse event.","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"12 12","pages":"E1453-E1457"},"PeriodicalIF":2.2,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11651917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Efficacy of anti-obesity medication (AOM) and endoscopic gastric remodeling (EGR): Analysis of combination therapy with optimal timing and agents. 抗肥胖药物（AOM）和内镜下胃重塑（EGR）的疗效：最佳时机和药物联合治疗的分析。

IF 2.2

Endoscopy International Open Pub Date : 2024-12-17 eCollection Date: 2024-12-01 DOI: 10.1055/a-2463-9784

Pichamol Jirapinyo, Aunchalee Jaroenlapnopparat, Christopher C Thompson

{"title":"Efficacy of anti-obesity medication (AOM) and endoscopic gastric remodeling (EGR): Analysis of combination therapy with optimal timing and agents.","authors":"Pichamol Jirapinyo, Aunchalee Jaroenlapnopparat, Christopher C Thompson","doi":"10.1055/a-2463-9784","DOIUrl":"10.1055/a-2463-9784","url":null,"abstract":"Background and study aims Endoscopic gastric remodeling (EGR) and anti-obesity medications (AOMs) are effective weight loss therapies. While the efficacy of EGR and AOMs has been established, the effect of combination therapy and its optimal approach remain unknown. Patients and methods This was a single-center retrospective review of prospectively collected data from patients who underwent EGR. Patients were categorized as: 1) monotherapy - EGR alone; 2) combination therapy - an AOM prescribed within 6 months of EGR; and 3) sequential therapy - an AOM prescribed greater than 6 months of EGR. Outcomes included percent total weight loss (%TWL) at 12 months, response rate (≥ 10%TWL at 12 months), and serious adverse event rate. Results A total of 208 patients were included. Of them, 65 (34%), 61 (31%), and 82 (35%) underwent monotherapy, combination therapy, and sequential therapy, respectively. At 12 months, patients who received EGR+GLP-1RA combination therapy achieved the greatest weight loss (23.7±4.6% TWL), while those who began with AOM followed by EGR more than 6 months later had the lowest weight loss (12.0±7.7%TWL) compared with monotherapy (17.3±10.0% TWL) ( P = 0.04 and 0.03, respectively). The response rate was 100% for EGR+GLP-1RA combination therapy and 56% for AOM followed by EGR sequential therapy ( P = 0.02). Conclusions Combining AOM with EGR appears to result in greater weight loss compared with other strategies, with GLP-1RA as the preferred agent and optimal initiation of both therapies occurring within 6 months of each other. Prolonged medication use prior to EGR appears to be associated with suboptimal weight loss, suggesting the importance of early referral for adjunctive therapy.","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"12 12","pages":"E1458-E1464"},"PeriodicalIF":2.2,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11651918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Endoscopic submucosal dissection of colorectal pedunculated polyps. 内镜下结肠直肠有蒂息肉的粘膜下解剖。

IF 2.2

Endoscopy International Open Pub Date : 2024-12-06 eCollection Date: 2024-12-01 DOI: 10.1055/a-2427-1948

Johanna Katharina Jakobs, Malte Zumblick, Susanne von Gerlach, Petros Stathopoulos, Sebastian Glas, Carsten Denkert, Ulrike Walburga Denzer

{"title":"Endoscopic submucosal dissection of colorectal pedunculated polyps.","authors":"Johanna Katharina Jakobs, Malte Zumblick, Susanne von Gerlach, Petros Stathopoulos, Sebastian Glas, Carsten Denkert, Ulrike Walburga Denzer","doi":"10.1055/a-2427-1948","DOIUrl":"10.1055/a-2427-1948","url":null,"abstract":"Background and study aims For pedunculated colon polyps, en bloc resection with inclusion of the polyp stalk is necessary to yield an accurate histologic staging. This can be challenging in cases of a large polyp and/or broad stalk using conventional snare resection. We evaluated the feasibility of endoscopic submucosal dissection (ESD) for large pedunculated polyps with broad stalks. Patients and methods Between February 2019 and November 2021 all patients with large pedunculated polyps defined as polyp diameter ≥ 20 mm and or a broad stalk > 5 mm were enrolled in the study. All polyps were resected in ESD technique with dissection of the polyp stalk at the base after injection. Results Twenty-five patients (male = 18, age mean: 67 years) were included. En bloc resection was achieved in 100% of the patients (25/25 polyps). Polyps were mainly located in the sigmoid (n = 19) and rectum (n = 3). Median polyp size was 30×25×17 mm. Histologic examination revealed the following results: adenoma low-grade intraepithelial neoplasia (LG-IEN): nine; high-grade intraepithelial neoplasia (HG-IEN): seven; pTis: three; adenoarcinoma: five (G1, pT1, L0, V0, Haggitt 3: 2/G2, pT1, L0, V0, Haggitt 3:2/G3, pT1, Bd3, V1, Haggitt 4: 1); other: 1. R0 resection rate was 100% and the curative resection rate yielded 96% (24/25) without severe adverse events. Conclusions ESD achieved high en bloc and R0 resection rates for large pedunculated polyps. In our collective, up to 32% of polyps already had adenocarcinoma, resulting in a high curative resection rate due to complete resection and subsequently accurate risk classification.","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"12 12","pages":"E1437-E1446"},"PeriodicalIF":2.2,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11624022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Correction: Enteroscopy-assisted ERCP in patients with surgically altered anatomy: Multicenter prospective registry (SAMISEN-B) using motorized spiral enteroscopy. 更正：在手术改变解剖结构的患者中，肠镜辅助ERCP：使用电动螺旋肠镜的多中心前瞻性登记（SAMISEN-B）。

IF 2.2

Endoscopy International Open Pub Date : 2024-12-04 eCollection Date: 2024-11-01 DOI: 10.1055/a-2494-3747

Tom G Moreels, Lars Aabakken, Marianna Arvanitakis, Mate Knabe, Torsten Beyna

引用次数: 0

Correction: Feasibility of newly designed rotatable sphincterotome for endoscopic sphincterotomy (with video). 修正：新设计的可旋转括约肌切开术用于内窥镜括约肌切开术的可行性（带视频）。

IF 2.2

Endoscopy International Open Pub Date : 2024-12-04 eCollection Date: 2024-11-01 DOI: 10.1055/a-2494-7841

Yasuki Hori, Kazuki Hayashi, Itaru Naitoh, Fumihiro Okumura, Kaiki Anbe, Katsuyuki Miyabe, Atsuyuki Hirano, Hiroki Takada, Naruomi Jinno, Michihiro Yoshida, Akihisa Kato, Kenta Kachi, Hidenori Sahashi, Akihisa Adachi, Tadashi Toyohara, Kayoko Kuno, Yusuke Kito, Hiromi Kataoka

引用次数: 0

Which is the better polyp detection metric: adenomas per colonoscopy or adenoma detection rate? A simulation modeling study. 哪一个是更好的息肉检测指标：腺瘤每结肠镜检查或腺瘤检出率？仿真建模研究。

IF 2.2

Endoscopy International Open Pub Date : 2024-11-28 eCollection Date: 2024-11-01 DOI: 10.1055/a-2417-6248

Todd MacKenzie, Sikai Xiao, William H Hisey, Christina M Robinson, Lynn Butterly, Joseph C Anderson

{"title":"Which is the better polyp detection metric: adenomas per colonoscopy or adenoma detection rate? A simulation modeling study.","authors":"Todd MacKenzie, Sikai Xiao, William H Hisey, Christina M Robinson, Lynn Butterly, Joseph C Anderson","doi":"10.1055/a-2417-6248","DOIUrl":"10.1055/a-2417-6248","url":null,"abstract":"Background and study aims We compared the ability of adenoma detection rate (ADR) and adenoma per colonoscopy (APC) to assess endoscopist detection, using statistical principles and simulations. Patients and methods We simulated a population of endoscopists and patients to compare the ability of ADR versus APC for capturing true endoscopist ability (TEA). We compared these rates with and without adjustment for patient and exam factors using multivariable models, and adjustment for imprecision due to low volume using empirical Bayes (shrinkage). Power calculations were used to compare the ability of ADR and APC to distinguish higher from lower rates over two time periods for an endoscopist. Results APC and ADR had similar discriminatory ability for assessing TEA. This increased with higher volumes and after adjusting for risk factors and low volume using shrinkage. Higher APC and ADRs had higher power for comparing endoscopist detection over two time periods, but APC was superior to ADR. For example, there was 29% power to distinguish APCs (n = 200 colonoscopies) 0.10 from 0.15, similar to the power (28%) to distinguish corresponding ADRs: 10% and 14%. However, at same volume (n = 200), the power to distinguish higher APC rates (0.50 vs.0.75) was greater (89%) than the power (78%) for corresponding ADRs (39% vs.53%). Conclusions Adjusting for patient and exam factors and/or using shrinkage techniques for lower-volume endoscopists can increase the correlation between TEA for both ADR and APC. For higher detection rates, APC offers more power than ADR in distinguishing differences in detection ability.","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"12 11","pages":"E1366-E1373"},"PeriodicalIF":2.2,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142749996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0