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©The Author(s) 2022.
World J Gastrointest Endosc. Nov 16, 2022; 14(11): 672-683
Published online Nov 16, 2022. doi: 10.4253/wjge.v14.i11.672
Published online Nov 16, 2022. doi: 10.4253/wjge.v14.i11.672
Table 1 Comparison of key outcomes between eligible procedures performed by medical and surgical specialists
| Medical, n = 716 | Surgical, n = 551 | P value | OR (95%CI) | |
| Patient age, median (IQR) | 65 (58-73) | 64 (56-71) | 0.04 | - |
| Patient gender (male %) | 49.7 (n = 356) | 48.8 (n = 269) | 0.75 | - |
| Cancer detection rate (%) | 2.7 (n = 19) | 4.7 (n = 26) | 0.052 | 0.55 (0.30-1.01) |
| CSPDR (%) | 46.6 (n = 325) | 35.6 (n = 187) | < 0.001 | 1.58 (1.25-1.99) |
| ADR (%) | 44 (n = 307) | 34 (n = 178) | < 0.001 | 1.53 (1.21-1.94) |
| SLDR (%) | 6.6 (n = 46) | 4.6 (n = 24) | 0.13 | 1.47 (0.89-2.45) |
Table 2 Comparison of outcomes between eligible procedures performed with and without trainees
| With trainees, n = 370 | Without trainees, n = 968 | P value | OR (95%CI) | |
| Patient age, median (IQR) | 64 (57-72) | 64 (57-72) | 0.83 | - |
| Patient gender (male %) | 53.5 (n = 198) | 47.4 (n = 463) | 0.06 | - |
| Cancer detection rate (%) | 4.1 (n = 15) | 3.3 (n = 32) | 0.51 | 1.24 (0.66-2.31) |
| CSPDR (%) | 41.4 (n = 147) | 42.7 (n = 400) | 0.67 | 0.95 (0.74-1.21) |
| ADR (%) | 38.9 (n = 138) | 40.4 (n = 378) | 0.62 | 0.94 (0.73-1.21) |
| SLDR (%) | 4.8 (n = 17) | 6.3 (n = 59) | 0.30 | 0.74 (0.43-1.30) |
Table 3 Comparison of outcomes between eligible procedures performed with medical and surgical trainees
| Medical trainees, n = 370 | Surgical trainees, n = 968 | P value | OR (95%CI) | |
| Patient age, median (IQR) | 59.5 (47-71) | 59 (48.75-69) | 0.30 | - |
| Patient gender (male %) | 49.7 (n = 166) | 52.3 (n = 206) | 0.49 | - |
| Cancer detection rate (%) | 2.3 (n = 5) | 3.3 (n = 10) | 0.49 | 0.68 (0.23-2.02) |
| CSPDR (%) | 38.2 (n = 81) | 32.5 (n = 94) | 0.19 | 1.28 (0.89-1.86) |
| ADR (%) | 36.3 (n = 77) | 29.1 (n = 84) | 0.09 | 1.39 (0.95-2.03) |
| SLDR (%) | 5.7 (n = 12) | 5.2 (n = 15) | 0.82 | 1.1 (0.5-2.39) |
Table 4 Comparison of key outcomes between participating hospitals
| Site 1 (n = 254) | Site 2 (n = 396) | Site 3 (n = 604) | Site 4 (n = 790) | Site 5 (n = 399) | P value | Overall (n = 2443) | |||
| Patient age, median (IQR) | 56 (46-66) | 61 (50-71) | 59.5 (49-70) | 61 (50-71) | 60 (50-71) | < 0.001 | 60 (50-70) | ||
| Patient gender (male %) | 56.7 (n = 144) | 45.7 (n = 181) | 48.0 (n = 290) | 48.4 (n = 382) | 50.4 (n = 201) | 0.08 | 49.0 (n = 1197) | ||
| Proceduralist | |||||||||
| Surgical (%) | 87.4 (n = 222) | 33.1 (n = 131) | 35.6 (n = 215) | 35.9 (n = 284) | 51.4 (n = 205) | < 0.001 | 43.3 (n = 1057) | ||
| Medical (%) | 12.6 (n = 32) | 66.9 (n = 265) | 64.1 (n = 387) | 50.5 (n = 399) | 48.4 (n = 193) | < 0.001 | 52.2 (n = 1276) | ||
| Trainee (%) | 59.4 (n = 151) | 38.9 (n = 154) | 8.1 (n = 49) | 28.1 (n = 222) | 38.1 (n = 152) | < 0.001 | 29.8 (n = 728) | ||
| Medical (%) | 0 (n = 0) | 61.7 (n = 95) | 91.8 (n = 45) | 39.2 (n = 87) | 70.4 (n = 107) | - | 45.9 (n = 334) | ||
| Surgical (%) | 100 (n = 151) | 38.3 (n = 59) | 8.2 (n = 4) | 60.8 (n = 135) | 29.6 (n = 45) | - | 54.1 (n = 394) | ||
| Inadequate bowel preparation (%) | 13.4 (n = 34) | 8.1 (n = 32) | 2.6 (n = 16) | 7.2 (n = 57) | 9.8 (n = 39) | < 0.001 | 7.3 (n = 178) | ||
| Indeterminate bowel preparation (%) | 0.0 (n = 0) | 2.8 (n = 11) | 1.5 (n = 9) | 4.3 (n = 34) | 22.1 (n = 88) | < 0.001 | 5.8 (n = 142) | ||
| Procedure completion (%) | 94.3 (n = 215) | 92.2 (n = 319) | 98.2 (n = 556) | 95.1 (n = 686) | 93.4 (n = 338) | < 0.001 | 95.1 (n = 2114) | ||
| Procedure completion (%) with adequate preparation | 98.0 (n = 195) | 94.5 (n = 294) | 99.2 (n = 537) | 98.0 (n = 627) | 96.3 (n = 233) | 0.99 | 97.5 (n = 1886) | ||
| Eligible procedures | 121 | 216 | 381 | 462 | 160 | 1340 | |||
| Cancer detection (%) | 5.0 (n = 6) | 2.3 (n = 5) | 2.9 (n = 11) | 3.5 (n = 16) | 5.6 (n = 9) | 0.38 | 3.5 (n = 47) | ||
| CSPDR (%) | 30.4 (n = 35) | 40.8 (n = 86) | 48.6 (n = 180) | 42.6 (n = 190) | 41.1 (n = 62) | 0.01 | 42.8 (n = 553) | ||
| ADR (%) | 27.8 (n = 32) | 39.3 (n = 83) | 45.7 (n = 169) | 39.5 (n = 176) | 37.7 (n = 57) | 0.01 | 40.0 (n = 517) | ||
| SLDR (%) | 2.6 (n = 3) | 5.2 (n = 11) | 5.1 (n = 19) | 7.4 (n = 33) | 6.6 (n = 10) | 0.31 | 5.9 (n = 76) | ||
Table 5 Multivariate regression analysis for detection rates of cancer, adenomas, and serrated lesions amongst eligible procedures
| Coefficient | OR (95%CI) | P value | |
| Cancer | |||
| Site | 0.11 | 1.11 (0.87-1.43) | 0.40 |
| Patient age | 0.04 | 1.04 (1.02-1.07) | < 0.001 |
| Patient gender (male) | -0.45 | 0.64 (0.36-1.14) | 0.13 |
| Trainee (present) | -0.12 | 0.89 (0.46-1.73) | 0.73 |
| Proceduralist (medical)1 | -0.61 | 0.54 (0.30-0.97) | 0.04 |
| Adenomas | |||
| Site | -0.01 | 0.99 (0.90-1.09) | 0.84 |
| Patient age | 0.04 | 1.04 (1.03-1.05) | < 0.001 |
| Patient gender (male) | -0.65 | 0.53 (0.42-0.65) | < 0.001 |
| Trainee (present) | 0.22 | 1.24 (0.96-1.61) | 0.10 |
| Proceduralist (medical)1 | 0.34 | 1.41 (1.13-1.76) | 0.002 |
| Serrated lesions | |||
| Site | 0.08 | 1.08 (0.90-1.3) | 0.42 |
| Patient age | 0.00 | 1.00 (0.99-1.02) | 0.57 |
| Patient gender (male) | 0.41 | 1.51 (0.99-2.29) | 0.05 |
| Trainee (present) | 0.26 | 1.29 (0.78-2.14) | 0.33 |
| Proceduralist (medical)1 | 0.28 | 1.32 (0.87-2.02) | 0.19 |
- Citation: Ow TW, Sukocheva OA, Tran V, Lin R, Lee SZ, Chu M, Angelica B, Rayner CK, Tse E, Iyngkaran G, Bampton PA. Quality of colonoscopy performed by medical or surgical specialists and trainees in five Australian hospitals. World J Gastrointest Endosc 2022; 14(11): 672-683
- URL: https://www.wjgnet.com/1948-5190/full/v14/i11/672.htm
- DOI: https://dx.doi.org/10.4253/wjge.v14.i11.672