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Physician characteristics associated with higher adenoma detection rate
Ateev Mehrotra1, Michele Morris2, Rebecca A Gourevitch3
1Harvard Medical School, Boston, Massachusetts, USA; Division of General Internal Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Gastrointestinal Endoscopy
|September 4, 2017
Summary
Physician specialty, gender, and training duration impact adenoma detection rates (ADR) during colonoscopies. Gastroenterologists, female physicians, and those recently out of residency show higher ADR, potentially improving colorectal cancer prevention.
Area of Science:
- Gastroenterology
- Public Health
- Medical Education
Background:
- Low adenoma detection rate (ADR) in colonoscopies increases colorectal cancer risk.
- Variations in physician ADR are not fully understood.
- Identifying factors associated with higher ADR is crucial for improving patient outcomes.
Purpose of the Study:
- To identify physician characteristics associated with higher adenoma detection rates (ADR).
- To understand the drivers of variation in ADR among physicians performing colonoscopies.
Main Methods:
- Retrospective cohort study analyzing 104,618 colonoscopies from October 2013 to September 2015.
- Natural language processing used to extract data from colonoscopy and pathology reports.
- Physician ADR was risk-adjusted for patient population and procedure indication.
Main Results:
- Mean ADR was 33.2% (range: 6.3%-58.7%).
- Higher ADR observed in female physicians (+4.2 percentage points) compared to male physicians.
- Gastroenterologists showed significantly higher ADR (+9.4 percentage points) than non-gastroenterologists.
- Physicians with ≤9 years post-residency had higher ADR (+6.0 percentage points) than those with 27-51 years of practice.
Conclusions:
- Gastroenterologists, female physicians, and recently trained physicians demonstrate superior adenoma detection during colonoscopies.
- These physician characteristics are linked to improved performance in identifying precancerous polyps.
- Findings suggest potential targets for quality improvement initiatives in colonoscopy practice.
