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Low adenoma detection rates are associated with development of interval cancer after 'negative' colonoscopy. Dr Susan Coe and colleagues noted that uncontrolled studies mandating longer withdrawal time, and other incentives, have not significantly improved adenoma detection rate. The team hypothesized that an endoscopist training program would increase adenoma detection rates. The Endoscopic Quality Improvement Program was an educational intervention for staff endoscopists. The team measured adenoma detection rate for a baseline period, then randomly assigned half of the 15 endoscopists to undergo Endoscopic Quality Improvement Program training. The team then examined baseline and post-training study adenoma detection rate for all endoscopists to evaluate the impact of training.  | | Training increased adenoma detection rate to 47% | | American Journal of Gastroenterology |
The doctors reported that a total of 1,200 procedures were completed in each of the 2 study phases. Patient characteristics were similar between randomization groups and between study phases. The research team assessed that the overall adenoma detection rate in baseline phase was 36% for both groups of endoscopists. In the post-training phase, the group of endoscopists randomized to Endoscopic Quality Improvement Program training had an increase in adenoma detection rate to 47%, whereas the adenoma detection rate for the group of endoscopists who were not trained remained unchanged at 35%. The researchers noted that the effect of training on the endoscopist-specific adenoma detection rate was estimated with an odds ratio of 1.7. Dr Coe's team concludes "Our results indicate that adenoma detection rate can be improved considerably through simple educational efforts." "Ultimately, a trial involving a larger number of endoscopists is needed to validate the utility of our training methods and determine whether improvements in adenoma detection rate lead to reduced colorectal cancer."
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