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Surveying ADR Knowledge and Practices Among US Gastroenterologists
1Indiana University School of Medicine.
Journal of Clinical Gastroenterology
|February 27, 2019
Summary
Gastroenterologists understand the importance of adenoma detection rate (ADR) but have misconceptions about its definition and measurement. Many are unaware of best practices for improving ADR and patient engagement remains low.
Area of Science:
- Gastroenterology
- Endoscopy
- Quality Improvement in Healthcare
Background:
- Adenoma detection rate (ADR) is a critical quality indicator for screening colonoscopies.
- Assessing gastroenterologists' knowledge and practices regarding ADR is essential for improving colonoscopy quality.
Purpose of the Study:
- To evaluate gastroenterologists' understanding of adenoma detection rate (ADR) definition and measurement.
- To identify current practices and perceived barriers to optimizing ADR.
- To assess the influence of patient inquiries on ADR tracking.
Main Methods:
- An online survey was distributed to board-certified gastroenterologists.
- Respondents performed over 80 colonoscopies monthly with 3-35 years of post-fellowship experience.
- Data collected on knowledge, practices, and perceived factors influencing ADR.
Main Results:
- 39% were unaware ADR applies only to screening colonoscopies; 76% incorrectly included sessile-serrated polyps.
- 51% misbelieved the 25% threshold is based on national averages.
- 75% ranked ADR as highly important, and 80% reported tracking it, with busy practices being a barrier.
- Perceived beneficial methods (caps, chromoendoscopy, bowel prep) and less valuable methods (high-definition colonoscopes, education) showed discrepancies with evidence.
- 57% did not share ADR with patients, and 59% reported no patient inquiries about ADR.
Conclusions:
- Gastroenterologists recognize ADR's importance but exhibit significant misconceptions regarding its definition, measurement, and effective improvement strategies.
- Patient engagement in ADR measurement is minimal.
- Further education and standardized practices are needed to enhance ADR and colonoscopy quality.
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