P189 Should you be worried if a trainee is performing your colonoscopy?
IntroductionWhen undertaking colonoscopy training, the focus of the trainee is often on reaching the caecum. Optimal mucosal inspection and polyp detection can lag behind. The most closely related quality indicator to reduced cancer mortality is adenoma detection rate (ADR). This study aims to disco...
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| Veröffentlicht in: | Gut 2023-06, Vol.72 (Suppl 2), p.A151-A151 |
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| creator | Goodhew, Rebecca Cama, Rigers Ghouse, Shamira Mehta, Ria Adu-Darko, Michael Wordsworth, Dominic Poo, Stephanie Fofaria, Rishi Beg, Sabina |
| description | IntroductionWhen undertaking colonoscopy training, the focus of the trainee is often on reaching the caecum. Optimal mucosal inspection and polyp detection can lag behind. The most closely related quality indicator to reduced cancer mortality is adenoma detection rate (ADR). This study aims to discover whether the presence of a trainee has any impact on ADR.MethodsThis study included all colonoscopies performed between 1st January and 31st March 2019 at three NHS trusts, encompassing five endoscopy units. Screening procedures and planned polypectomies were excluded. Procedures were categorised according to whether a trainee was present or not. We compared sedation use, comfort score, withdrawal time (WT) and ADR between these two cohorts.ResultsA total of 3893 colonoscopies were included in this study, of which 591 (15.9%) were undertaken by trainees. of these 410 were for the investigation of symptoms, while 171 were for a surveillance indication. Demographics such as age and gender were comparable between the trainee and non-trainee cohorts. When comparing operating characteristics between the trainee and non-trainee cohorts average use of midazolam was 1.46 mg vs 1.40 mg respectively (p=0.64) and fentanyl 41.11 mcg vs 41.06 mcg (p=0.635), with 54.2% vs 43.8% (p |
| doi_str_mv | 10.1136/gutjnl-2023-BSG.258 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_bmj_j</sourceid><recordid>TN_cdi_proquest_journals_2827409018</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2827409018</sourcerecordid><originalsourceid>FETCH-LOGICAL-b688-12f0ca5e7fd4879133430c581c78cfe86a1663c563fb91370967ce0256d8d0323</originalsourceid><addsrcrecordid>eNpFkEFLwzAYhoMoOKe_wEvAc7YvSZt8PYkOnYOBwnYPbZrMlq6Z6Yrs5sU_6i-xY4Kn7_A-vO_HQ8gthwnnUk03_b5uGyZASPa4mk9EimdkxBOFTArEczIC4JqlOskuyVXX1QCAmPERWbxxzH6-vlfvoW9Kegg9LRz9DDFWrqSVpzndx7xqnaNVR3cu-hC3Vbs5kpHa0IQ2dDbsDvfX5MLnTedu_u6YrJ-f1rMXtnydL2YPS1YoRMaFB5unTvsyQZ1xKRMJNkVuNVrvUOVcKWlTJX0xpBoypa0DkaoSS5BCjsndqXYXw0fvur2ph0_aYdEIFDqBDDgO1PREFdv6H-BgjrrMSZc56jKDLjPokr_zg17L</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2827409018</pqid></control><display><type>article</type><title>P189 Should you be worried if a trainee is performing your colonoscopy?</title><source>PubMed Central</source><creator>Goodhew, Rebecca ; Cama, Rigers ; Ghouse, Shamira ; Mehta, Ria ; Adu-Darko, Michael ; Wordsworth, Dominic ; Poo, Stephanie ; Fofaria, Rishi ; Beg, Sabina</creator><creatorcontrib>Goodhew, Rebecca ; Cama, Rigers ; Ghouse, Shamira ; Mehta, Ria ; Adu-Darko, Michael ; Wordsworth, Dominic ; Poo, Stephanie ; Fofaria, Rishi ; Beg, Sabina</creatorcontrib><description>IntroductionWhen undertaking colonoscopy training, the focus of the trainee is often on reaching the caecum. Optimal mucosal inspection and polyp detection can lag behind. The most closely related quality indicator to reduced cancer mortality is adenoma detection rate (ADR). This study aims to discover whether the presence of a trainee has any impact on ADR.MethodsThis study included all colonoscopies performed between 1st January and 31st March 2019 at three NHS trusts, encompassing five endoscopy units. Screening procedures and planned polypectomies were excluded. Procedures were categorised according to whether a trainee was present or not. We compared sedation use, comfort score, withdrawal time (WT) and ADR between these two cohorts.ResultsA total of 3893 colonoscopies were included in this study, of which 591 (15.9%) were undertaken by trainees. of these 410 were for the investigation of symptoms, while 171 were for a surveillance indication. Demographics such as age and gender were comparable between the trainee and non-trainee cohorts. When comparing operating characteristics between the trainee and non-trainee cohorts average use of midazolam was 1.46 mg vs 1.40 mg respectively (p=0.64) and fentanyl 41.11 mcg vs 41.06 mcg (p=0.635), with 54.2% vs 43.8% (p<0.001), noted to be comfortable. Trainee average WT was 10.1 minutes vs 8.9 minutes in non-trainees (p<0.001). When examining outcomes, the ADR in a diagnostic procedure was 15.8% if a trainee was present but 17.2% if not (p=0.489) and during a surveillance procedure 32.1% if a trainee was present but 37.1% if not (p=0.224).ConclusionsThis study demonstrates that colonoscopy withdrawal is adequately supervised with no deleterious impact on ADR when the procedure is undertaken by a trainee.</description><identifier>ISSN: 0017-5749</identifier><identifier>EISSN: 1468-3288</identifier><identifier>DOI: 10.1136/gutjnl-2023-BSG.258</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd and British Society of Gastroenterology</publisher><subject>Colon ; Colonoscopy ; Endoscopy ; Fentanyl ; Midazolam ; Polyps ; Poster presentations ; Surveillance</subject><ispartof>Gut, 2023-06, Vol.72 (Suppl 2), p.A151-A151</ispartof><rights>Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2023 Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids></links><search><creatorcontrib>Goodhew, Rebecca</creatorcontrib><creatorcontrib>Cama, Rigers</creatorcontrib><creatorcontrib>Ghouse, Shamira</creatorcontrib><creatorcontrib>Mehta, Ria</creatorcontrib><creatorcontrib>Adu-Darko, Michael</creatorcontrib><creatorcontrib>Wordsworth, Dominic</creatorcontrib><creatorcontrib>Poo, Stephanie</creatorcontrib><creatorcontrib>Fofaria, Rishi</creatorcontrib><creatorcontrib>Beg, Sabina</creatorcontrib><title>P189 Should you be worried if a trainee is performing your colonoscopy?</title><title>Gut</title><addtitle>Gut</addtitle><description>IntroductionWhen undertaking colonoscopy training, the focus of the trainee is often on reaching the caecum. Optimal mucosal inspection and polyp detection can lag behind. The most closely related quality indicator to reduced cancer mortality is adenoma detection rate (ADR). This study aims to discover whether the presence of a trainee has any impact on ADR.MethodsThis study included all colonoscopies performed between 1st January and 31st March 2019 at three NHS trusts, encompassing five endoscopy units. Screening procedures and planned polypectomies were excluded. Procedures were categorised according to whether a trainee was present or not. We compared sedation use, comfort score, withdrawal time (WT) and ADR between these two cohorts.ResultsA total of 3893 colonoscopies were included in this study, of which 591 (15.9%) were undertaken by trainees. of these 410 were for the investigation of symptoms, while 171 were for a surveillance indication. Demographics such as age and gender were comparable between the trainee and non-trainee cohorts. When comparing operating characteristics between the trainee and non-trainee cohorts average use of midazolam was 1.46 mg vs 1.40 mg respectively (p=0.64) and fentanyl 41.11 mcg vs 41.06 mcg (p=0.635), with 54.2% vs 43.8% (p<0.001), noted to be comfortable. Trainee average WT was 10.1 minutes vs 8.9 minutes in non-trainees (p<0.001). When examining outcomes, the ADR in a diagnostic procedure was 15.8% if a trainee was present but 17.2% if not (p=0.489) and during a surveillance procedure 32.1% if a trainee was present but 37.1% if not (p=0.224).ConclusionsThis study demonstrates that colonoscopy withdrawal is adequately supervised with no deleterious impact on ADR when the procedure is undertaken by a trainee.</description><subject>Colon</subject><subject>Colonoscopy</subject><subject>Endoscopy</subject><subject>Fentanyl</subject><subject>Midazolam</subject><subject>Polyps</subject><subject>Poster presentations</subject><subject>Surveillance</subject><issn>0017-5749</issn><issn>1468-3288</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNpFkEFLwzAYhoMoOKe_wEvAc7YvSZt8PYkOnYOBwnYPbZrMlq6Z6Yrs5sU_6i-xY4Kn7_A-vO_HQ8gthwnnUk03_b5uGyZASPa4mk9EimdkxBOFTArEczIC4JqlOskuyVXX1QCAmPERWbxxzH6-vlfvoW9Kegg9LRz9DDFWrqSVpzndx7xqnaNVR3cu-hC3Vbs5kpHa0IQ2dDbsDvfX5MLnTedu_u6YrJ-f1rMXtnydL2YPS1YoRMaFB5unTvsyQZ1xKRMJNkVuNVrvUOVcKWlTJX0xpBoypa0DkaoSS5BCjsndqXYXw0fvur2ph0_aYdEIFDqBDDgO1PREFdv6H-BgjrrMSZc56jKDLjPokr_zg17L</recordid><startdate>20230618</startdate><enddate>20230618</enddate><creator>Goodhew, Rebecca</creator><creator>Cama, Rigers</creator><creator>Ghouse, Shamira</creator><creator>Mehta, Ria</creator><creator>Adu-Darko, Michael</creator><creator>Wordsworth, Dominic</creator><creator>Poo, Stephanie</creator><creator>Fofaria, Rishi</creator><creator>Beg, Sabina</creator><general>BMJ Publishing Group Ltd and British Society of Gastroenterology</general><general>BMJ Publishing Group LTD</general><scope>K9.</scope></search><sort><creationdate>20230618</creationdate><title>P189 Should you be worried if a trainee is performing your colonoscopy?</title><author>Goodhew, Rebecca ; Cama, Rigers ; Ghouse, Shamira ; Mehta, Ria ; Adu-Darko, Michael ; Wordsworth, Dominic ; Poo, Stephanie ; Fofaria, Rishi ; Beg, Sabina</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b688-12f0ca5e7fd4879133430c581c78cfe86a1663c563fb91370967ce0256d8d0323</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Colon</topic><topic>Colonoscopy</topic><topic>Endoscopy</topic><topic>Fentanyl</topic><topic>Midazolam</topic><topic>Polyps</topic><topic>Poster presentations</topic><topic>Surveillance</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Goodhew, Rebecca</creatorcontrib><creatorcontrib>Cama, Rigers</creatorcontrib><creatorcontrib>Ghouse, Shamira</creatorcontrib><creatorcontrib>Mehta, Ria</creatorcontrib><creatorcontrib>Adu-Darko, Michael</creatorcontrib><creatorcontrib>Wordsworth, Dominic</creatorcontrib><creatorcontrib>Poo, Stephanie</creatorcontrib><creatorcontrib>Fofaria, Rishi</creatorcontrib><creatorcontrib>Beg, Sabina</creatorcontrib><collection>ProQuest Health & Medical Complete (Alumni)</collection><jtitle>Gut</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Goodhew, Rebecca</au><au>Cama, Rigers</au><au>Ghouse, Shamira</au><au>Mehta, Ria</au><au>Adu-Darko, Michael</au><au>Wordsworth, Dominic</au><au>Poo, Stephanie</au><au>Fofaria, Rishi</au><au>Beg, Sabina</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>P189 Should you be worried if a trainee is performing your colonoscopy?</atitle><jtitle>Gut</jtitle><stitle>Gut</stitle><date>2023-06-18</date><risdate>2023</risdate><volume>72</volume><issue>Suppl 2</issue><spage>A151</spage><epage>A151</epage><pages>A151-A151</pages><issn>0017-5749</issn><eissn>1468-3288</eissn><abstract>IntroductionWhen undertaking colonoscopy training, the focus of the trainee is often on reaching the caecum. Optimal mucosal inspection and polyp detection can lag behind. The most closely related quality indicator to reduced cancer mortality is adenoma detection rate (ADR). This study aims to discover whether the presence of a trainee has any impact on ADR.MethodsThis study included all colonoscopies performed between 1st January and 31st March 2019 at three NHS trusts, encompassing five endoscopy units. Screening procedures and planned polypectomies were excluded. Procedures were categorised according to whether a trainee was present or not. We compared sedation use, comfort score, withdrawal time (WT) and ADR between these two cohorts.ResultsA total of 3893 colonoscopies were included in this study, of which 591 (15.9%) were undertaken by trainees. of these 410 were for the investigation of symptoms, while 171 were for a surveillance indication. Demographics such as age and gender were comparable between the trainee and non-trainee cohorts. When comparing operating characteristics between the trainee and non-trainee cohorts average use of midazolam was 1.46 mg vs 1.40 mg respectively (p=0.64) and fentanyl 41.11 mcg vs 41.06 mcg (p=0.635), with 54.2% vs 43.8% (p<0.001), noted to be comfortable. Trainee average WT was 10.1 minutes vs 8.9 minutes in non-trainees (p<0.001). When examining outcomes, the ADR in a diagnostic procedure was 15.8% if a trainee was present but 17.2% if not (p=0.489) and during a surveillance procedure 32.1% if a trainee was present but 37.1% if not (p=0.224).ConclusionsThis study demonstrates that colonoscopy withdrawal is adequately supervised with no deleterious impact on ADR when the procedure is undertaken by a trainee.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd and British Society of Gastroenterology</pub><doi>10.1136/gutjnl-2023-BSG.258</doi></addata></record> |
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| source | PubMed Central |
| subjects | Colon Colonoscopy Endoscopy Fentanyl Midazolam Polyps Poster presentations Surveillance |
| title | P189 Should you be worried if a trainee is performing your colonoscopy? |
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