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Patient, Physician, and Procedure Characteristics Are Independently Predictive of Polyp Detection Rates in Clinical Practice.

Publication ,  Journal Article
Jawitz, NG; Gellad, ZF; Lin, L; Wood, RK; Leiman, DA
Published in: Dig Dis Sci
August 2021

BACKGROUND: Variability in colon polyp detection impacts patient outcomes. However, the relative influence of physician, patient, and procedure-specific factors on polyp detection is unclear. Therefore, determining how these factors contribute to adenoma and sessile serrated polyp (SSP) detection is important to contextualize measures of colonoscopy quality such as adenoma detection rate and patient outcomes. AIMS: To determine the relative contribution of physician, patient, and procedure-specific factors in total polyp, adenoma, and SSP detection rates. METHODS: We performed a retrospective study of patients undergoing screening colonoscopy and used a two-level generalized linear mixed regression model to identify factors associated with polyp detection. RESULTS: 7799 average risk screening colonoscopies were performed between July 2016 and October 2017. The patient factor most strongly associated with increased risk of adenoma and sessile serrated polyp detection was white race (OR 1.21, 95% CI 1.05-1.39 and OR 3.17, 95% CI 2.34-4.30, respectively). Adenomatous (OR 1.92, 95% CI 1.04-3.57) and sessile serrated polyps (OR 5.56, 95% CI 1.37-20.0) were more likely to be found during procedures performed with anesthesia care as compared to those with moderate sedation. Physician with a luminal gastrointestinal focus had increased odds of adenoma detection (OR 1.61, 95% CI 1.02-2.50). CONCLUSIONS: In a multi-level model accounting for clustering effects, we identified patient, provider and procedural factors independently influence adenoma and sessile serrated polyp detection. Our findings suggest that to compare polyp detection rates between endoscopists, even at the same institution, risk adjustment by characteristics of the patient population and practice is necessary.

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Published In

Dig Dis Sci

DOI

EISSN

1573-2568

Publication Date

August 2021

Volume

66

Issue

8

Start / End Page

2570 / 2577

Location

United States

Related Subject Headings

  • Physicians
  • Odds Ratio
  • Middle Aged
  • Male
  • Humans
  • Gastroenterology & Hepatology
  • Female
  • Colonoscopy
  • Colonic Polyps
  • Colonic Neoplasms
 

Citation

APA
Chicago
ICMJE
MLA
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Jawitz, N. G., Gellad, Z. F., Lin, L., Wood, R. K., & Leiman, D. A. (2021). Patient, Physician, and Procedure Characteristics Are Independently Predictive of Polyp Detection Rates in Clinical Practice. Dig Dis Sci, 66(8), 2570–2577. https://doi.org/10.1007/s10620-020-06592-w
Jawitz, Nicole G., Ziad F. Gellad, Li Lin, Richard K. Wood, and David A. Leiman. “Patient, Physician, and Procedure Characteristics Are Independently Predictive of Polyp Detection Rates in Clinical Practice.Dig Dis Sci 66, no. 8 (August 2021): 2570–77. https://doi.org/10.1007/s10620-020-06592-w.
Jawitz NG, Gellad ZF, Lin L, Wood RK, Leiman DA. Patient, Physician, and Procedure Characteristics Are Independently Predictive of Polyp Detection Rates in Clinical Practice. Dig Dis Sci. 2021 Aug;66(8):2570–7.
Jawitz, Nicole G., et al. “Patient, Physician, and Procedure Characteristics Are Independently Predictive of Polyp Detection Rates in Clinical Practice.Dig Dis Sci, vol. 66, no. 8, Aug. 2021, pp. 2570–77. Pubmed, doi:10.1007/s10620-020-06592-w.
Jawitz NG, Gellad ZF, Lin L, Wood RK, Leiman DA. Patient, Physician, and Procedure Characteristics Are Independently Predictive of Polyp Detection Rates in Clinical Practice. Dig Dis Sci. 2021 Aug;66(8):2570–2577.
Journal cover image

Published In

Dig Dis Sci

DOI

EISSN

1573-2568

Publication Date

August 2021

Volume

66

Issue

8

Start / End Page

2570 / 2577

Location

United States

Related Subject Headings

  • Physicians
  • Odds Ratio
  • Middle Aged
  • Male
  • Humans
  • Gastroenterology & Hepatology
  • Female
  • Colonoscopy
  • Colonic Polyps
  • Colonic Neoplasms