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Choi HH, Sung SY, Lee BI, Cho H, Jung Y, Park JM, Cho YS, Lee KM, Kim SW, Choi H, Chae HS, Choi MG. The Effect of Intervention for Improving Colonoscopy Quality Is Associated with the Personality Traits of Endoscopists. Gut Liver 2024; 18:265-274. [PMID: 37158042 PMCID: PMC10938159 DOI: 10.5009/gnl220280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 12/09/2022] [Accepted: 02/13/2023] [Indexed: 05/10/2023] Open
Abstract
Background/Aims This study investigated whether the personality traits of endoscopists are associated with the effect of interventions for the improvement of colonoscopy quality. Methods This prospective, multicenter, single-blind study was performed with 13 endoscopists in three health screening centers over a 12-month period. Quality indicators (QIs), including adenoma detection rate (ADR), polyp detection rate (PDR), and withdrawal time, were measured every 3 months. Consecutive interventions for the improvement of colonoscopy quality were conducted every 3 months, which included the personal notification of QIs, the in-group notification of QIs, and finally a targeted "quality education" session. The personality traits of each endoscopist were evaluated for perfectionism, fear of negative evaluation, and cognitive flexibility after the last QI assessment. Results A total of 4,095 colonoscopies were evaluated to measure the QIs of the individual endoscopists for 12 months. The mean ADR, PDR, and withdrawal time of the 13 endoscopists were 32.3%, 47.7%, and 394 seconds at baseline and increased to 39.0%, 55.1%, and 430 seconds by the end of the study (p=0.003, p=0.006, and p=0.004, respectively). Among the three interventions, only quality education significantly improved QIs: ADR, 36.0% to 39.0% (odds ratio, 1.28; 95% confidence interval, 1.01 to 1.63). The improvement of ADR and PDR by education was significantly associated with perfectionism (r=0.617, p=0.033 and r=0.635, p=0.027, respectively) and fear of negative evaluation (r=0.704, p=0.011 and r=0.761, p=0.004, respectively). Conclusions Education can improve colonoscopy quality, and its effect size is associated with an endoscopist's personal traits such as perfectionism and fear of negative evaluation (Clinical-Trials.gov Registry NCT03796169).
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Affiliation(s)
- Hyun Ho Choi
- Division of Gastroenterology, Department of Internal Medicine, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Soo-Yoon Sung
- Department of Radiation Oncology, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Bo-In Lee
- Division of Gastroenterology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Catholic Photomedicine Research Institute, The Catholic University of Korea, Seoul, Korea
| | - Hyun Cho
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yunho Jung
- Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Jae Myung Park
- Division of Gastroenterology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Catholic Photomedicine Research Institute, The Catholic University of Korea, Seoul, Korea
| | - Young-Seok Cho
- Division of Gastroenterology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kang-Moon Lee
- Division of Gastroenterology, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sang Woo Kim
- Division of Gastroenterology, Department of Internal Medicine, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hwang Choi
- Division of Gastroenterology, Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hiun-Suk Chae
- Division of Gastroenterology, Department of Internal Medicine, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Myung-Gyu Choi
- Division of Gastroenterology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Catholic Photomedicine Research Institute, The Catholic University of Korea, Seoul, Korea
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Wu L, Shi C, Li J, Dong Z, Zhou W, Yin A, Li Y, Deng Y, Xu M, Hu S, Pan J, Ai Y, Liu J, Zhu Y, Tao X, Wang J, Du H, Zeng X, Yu H. Development and Evaluation of a Surveillance System for Follow-Up After Colorectal Polypectomy. JAMA Netw Open 2023; 6:e2334822. [PMID: 37728926 DOI: 10.1001/jamanetworkopen.2023.34822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/22/2023] Open
Abstract
Importance The adherence of physicians and patients to published colorectal postpolypectomy surveillance guidelines varies greatly, and patient follow-up is critical but time consuming. Objectives To evaluate the accuracy of an automatic surveillance (AS) system in identifying patients after polypectomy, assigning surveillance intervals for different risks of patients, and proactively following up with patients on time. Design, Setting, and Participants In this diagnostic/prognostic study, endoscopic and pathological reports of 47 544 patients undergoing colonoscopy at 3 hospitals between January 1, 2017, and June 30, 2022, were collected to develop an AS system based on natural language processing. The performance of the AS system was fully evaluated in internal and external tests according to 5 guidelines worldwide and compared with that of physicians. A multireader, multicase (MRMC) trial was conducted to evaluate use of the AS system and physician guideline adherence, and prospective data were collected to evaluate the success rate in contacting patients and the association with reduced human workload. Data analysis was conducted from July to September 2022. Exposures Assistance of the AS system. Main Outcomes and Measures The accuracy of the system in identifying patients after polypectomy, stratifying patient risk levels, and assigning surveillance intervals in internal (Renmin Hospital of Wuhan University), external 1 (Wenzhou Central Hospital), and external 2 (The First People's Hospital of Yichang) test sets; the accuracy of physicians and their time burden with and without system assistance; and the rate of successfully informed patients of the system were evaluated. Results Test sets for 16 106 patients undergoing colonoscopy (mean [SD] age, 51.90 [13.40] years; 7690 females [47.75%]) were evaluated. In internal, external 1, and external 2 test sets, the system had an overall accuracy of 99.91% (95% CI, 99.83%-99.95%), 99.54% (95% CI, 99.30%-99.70%), and 99.77% (95% CI, 99.41%-99.91%), respectively, for identifying types of patients and achieved an overall accuracy of at least 99.30% (95% CI, 98.67%-99.63%) in the internal test set, 98.89% (95% CI, 98.33%-99.27%) in external test set 1, and 98.56% (95% CI, 95.86%-99.51%) in external test set 2 for stratifying patient risk levels and assigning surveillance intervals according to 5 guidelines. The system was associated with increased mean (SD) accuracy among physicians vs no AS system in 105 patients (98.67% [1.28%] vs 78.10% [18.01%]; P = .04) in the MRMC trial. In a prospective trial, the AS system successfully informed 82 of 88 patients (93.18%) and was associated with reduced burden of follow-up time vs no AS system (0 vs 2.86 h). Conclusions and Relevance This study found that an AS system was associated with improved adherence to guidelines among physicians and reduced workload among physicians and nurses.
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Affiliation(s)
- Lianlian Wu
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Hubei Key Laboratory of Digestive System, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Engineering Research Center for Artificial Intelligence Endoscopy Interventional Treatment of Hubei Province, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
| | - Conghui Shi
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Hubei Key Laboratory of Digestive System, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Engineering Research Center for Artificial Intelligence Endoscopy Interventional Treatment of Hubei Province, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
| | - Jia Li
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Hubei Key Laboratory of Digestive System, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Engineering Research Center for Artificial Intelligence Endoscopy Interventional Treatment of Hubei Province, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
| | - Zehua Dong
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Hubei Key Laboratory of Digestive System, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Engineering Research Center for Artificial Intelligence Endoscopy Interventional Treatment of Hubei Province, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
| | - Wei Zhou
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Hubei Key Laboratory of Digestive System, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Engineering Research Center for Artificial Intelligence Endoscopy Interventional Treatment of Hubei Province, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
| | - Anning Yin
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Hubei Key Laboratory of Digestive System, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Engineering Research Center for Artificial Intelligence Endoscopy Interventional Treatment of Hubei Province, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
| | - Yanxia Li
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Hubei Key Laboratory of Digestive System, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Engineering Research Center for Artificial Intelligence Endoscopy Interventional Treatment of Hubei Province, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
| | - Yunchao Deng
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Hubei Key Laboratory of Digestive System, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Engineering Research Center for Artificial Intelligence Endoscopy Interventional Treatment of Hubei Province, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
| | - Ming Xu
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Hubei Key Laboratory of Digestive System, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Engineering Research Center for Artificial Intelligence Endoscopy Interventional Treatment of Hubei Province, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
| | - Shan Hu
- School of Computer Sciences of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
| | - Jie Pan
- Department of Gastroenterology, Wenzhou Central Hospital, Wenzhou, Zhejiang 325000, People's Republic of China
| | - Yaowei Ai
- Department of Gastroenterology, The People's Hospital of China Three Gorges University, The First People's Hospital of Yichang, Yichang, Hubei 443000, P.R. China
| | - Jun Liu
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Nursing Department of Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
| | - Yijie Zhu
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Hubei Key Laboratory of Digestive System, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Engineering Research Center for Artificial Intelligence Endoscopy Interventional Treatment of Hubei Province, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
| | - Xiao Tao
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Hubei Key Laboratory of Digestive System, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Engineering Research Center for Artificial Intelligence Endoscopy Interventional Treatment of Hubei Province, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
| | - Junxiao Wang
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Hubei Key Laboratory of Digestive System, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Engineering Research Center for Artificial Intelligence Endoscopy Interventional Treatment of Hubei Province, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
| | - Hongliu Du
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Hubei Key Laboratory of Digestive System, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Engineering Research Center for Artificial Intelligence Endoscopy Interventional Treatment of Hubei Province, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
| | - Xiaoquan Zeng
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Hubei Key Laboratory of Digestive System, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Engineering Research Center for Artificial Intelligence Endoscopy Interventional Treatment of Hubei Province, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
| | - Honggang Yu
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Hubei Key Laboratory of Digestive System, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
- Engineering Research Center for Artificial Intelligence Endoscopy Interventional Treatment of Hubei Province, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China
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5
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Sung JJY, Chiu HM, Lieberman D, Kuipers EJ, Rutter MD, Macrae F, Yeoh KG, Ang TL, Chong VH, John S, Li J, Wu K, Ng SSM, Makharia GK, Abdullah M, Kobayashi N, Sekiguchi M, Byeon JS, Kim HS, Parry S, Cabral-Prodigalidad PAI, Wu DC, Khomvilai S, Lui RN, Wong S, Lin YM, Dekker E. Third Asia-Pacific consensus recommendations on colorectal cancer screening and postpolypectomy surveillance. Gut 2022; 71:2152-2166. [PMID: 36002247 DOI: 10.1136/gutjnl-2022-327377] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 08/07/2022] [Indexed: 12/09/2022]
Abstract
The Asia-Pacific region has the largest number of cases of colorectal cancer (CRC) and one of the highest levels of mortality due to this condition in the world. Since the publishing of two consensus recommendations in 2008 and 2015, significant advancements have been made in our knowledge of epidemiology, pathology and the natural history of the adenoma-carcinoma progression. Based on the most updated epidemiological and clinical studies in this region, considering literature from international studies, and adopting the modified Delphi process, the Asia-Pacific Working Group on Colorectal Cancer Screening has updated and revised their recommendations on (1) screening methods and preferred strategies; (2) age for starting and terminating screening for CRC; (3) screening for individuals with a family history of CRC or advanced adenoma; (4) surveillance for those with adenomas; (5) screening and surveillance for sessile serrated lesions and (6) quality assurance of screening programmes. Thirteen countries/regions in the Asia-Pacific region were represented in this exercise. International advisors from North America and Europe were invited to participate.
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Affiliation(s)
| | - Han-Mo Chiu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.,Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | | | | | | | - Finlay Macrae
- The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | | | | | - Vui Heng Chong
- Raja Isteri Pengiran Anak Saleha Hospital, Brunei, Brunei Darussalam
| | - Sneha John
- Digestive Health, Endoscopy, Gold Coast University Hospital, Southport, Queensland, Australia
| | - Jingnan Li
- Peking Union Medical College Hospital, Beijing, China
| | - Kaichun Wu
- Fourth Military Medical University, Xi'an, China
| | - Simon S M Ng
- The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | | | - Murdani Abdullah
- Division of Gastroenterology, Pancreatibiliar and Digestive Endoscopy. Department of Internal Medicine, Hospital Dr Cipto Mangunkusumo, Jakarta, Indonesia.,Human Cancer Research Center. IMERI. Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Nozomu Kobayashi
- Cancer Screening Center/ Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.,Division of Screening Technology, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Masau Sekiguchi
- Cancer Screening Center/ Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.,Division of Screening Technology, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Jeong-Sik Byeon
- University of Ulsan College of Medicine, Seoul, Korea (the Republic of)
| | - Hyun-Soo Kim
- Yonsei University, Seoul, Korea (the Republic of)
| | - Susan Parry
- National Bowel Screening Programme, New Zealand Ministry of Health, Auckland, New Zealand.,The University of Auckland, Auckland, New Zealand
| | | | | | | | - Rashid N Lui
- Division of Gastroenterology and Hepatology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, Hong Kong.,Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Sunny Wong
- Lee Kong Chian School of Medicine, Singapore
| | - Yu-Min Lin
- Shin Kong Wu Ho Su Memorial Hospital, Taipei, Taiwan
| | - E Dekker
- Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
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