腺瘤检测和内镜医生:评估外包在英国内镜服务中的影响
Mo Thoufeeq1, Cyrias Makkattil1, Nadha Rahim1
1Gastroenterology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, GBR.
Cureus
|July 4, 2025
概括
医院内镜师检测出比内部人员更多的临床显著的息肉和结直肠癌. 这表明诊断产量的潜在变化,突出显示了在不同内镜人员配置模型中需要标准化培训和绩效审计的需要.
科学领域:
- 胃肠病学 胃肠病学
- 临床内镜检查 临床内镜检查
- 医疗保健服务研究 医疗服务研究
背景情况:
- 英国内镜服务经常使用外包来补充人员.
- 内部内镜师对诊断结果的影响需要澄清.
研究的目的:
- 为了比较医院内科和内部内科内镜师之间的多和结直肠癌检测率.
- 评估不同内镜人员配置模型的诊断产量.
主要方法:
- 对2,173次诊断结肠镜检查 (2022年3月至2024年2月) 的回顾性观察性研究.
- 医院内镜师 (n=968) 和内部内镜师 (n=1,205) 的比较.
- 息肉的组织学匹配;使用基平方和t测试进行统计分析.
主要成果:
- 医院内镜检查人员显示,管状腺瘤 (21.2%与14.9%相比),多发性息肉 (8.5%与5%) 和结直肠癌 (1.7%与0.5%) 的检测率更高.
- 内源内镜检测出更多的小/管状小腺瘤 (3.2%对1.3%).
- 更多的内部内镜师的手术没有发现多体 (73%对63.5%).
结论:
- 医院内镜师在大多数显著的息肉和结肠直肠癌中实现了更高的检测率.
- 这些发现表明,诊断产量与内镜师的作用相关的潜在变化.
- 需要对员工配置模式中的培训,审计和绩效标准进行进一步评估.
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