增加结肠镜检查能力的举措 - - 对多体检测有影响吗? 英国国家内镜数据库分析
Liya Lu1, Jamie Catlow1,2,3, Matthew D Rutter1,2
1Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne, United Kingdom.
Endoscopy
|November 21, 2023
概括
增加周末或内部人员的结肠镜检查能力可能会降低多体检测率. 质量监测对于确保患者安全和有效的癌症查至关重要. 需要对这些变异进行进一步的研究.
科学领域:
- 胃肠病学 胃肠病学
- 内镜检查是指内镜检查.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 常规内镜需求往往超过容量,导致像周末工作或使用内部人员这样的策略.
- 人们担心,这些提高能力的举措可能会损害内镜手术的质量.
- 息肉检测是结肠镜检查中的一个关键质量指标.
研究的目的:
- 调查周末与周日以及内部与标准结肠镜检查程序对多检测的影响.
- 分析在不同的程序设置中检测的聚的检测率和检测的聚的平均数量.
主要方法:
- 来自英国国家内镜数据库 (01/01-04/04/2019) 的诊断结肠镜的全国性,回顾性,横截面研究.
- 主要结局:多的平均数量 (MNP);二次结局:多检测率 (PDR).
- 多级混合效应回归分析,根据患者和程序因素进行调整,以评估程序日/类型和结果之间的关联.
主要成果:
- 分析了超过92,000次结肠镜检查,其中21.5%在周末进行,10.7%使用内部人员进行.
- 与周日和标准手术相比,周末手术 (IRR 0.86) 和内部手术 (IRR 0.91) 中的多细胞平均数量 (MNP) 显著下降.
- 息肉检测率 (PDR) 与周末和内部采购程序具有相似的负面关联.
结论:
- 增加结肠镜检查能力的策略,如周末工作或外包人员,可能与减少多体检测有关.
- 这些发现突出了对质量的潜在负面影响,需要仔细监测.
- 需要进一步的研究,以了解这种多检测变异背后的原因.
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