Division of Gastroenterology and Hepatology, Medical College of Wisconsin, 9200 W Wisconsin Ave, Milwaukee, WI, 53226, USA,
Dig Dis Sci. 2013 Dec;58(12):3413-21. doi: 10.1007/s10620-013-2701-2. Epub 2013 May 22.
Conflicting data regarding the impact of fellow involvement during colonoscopy on the adenoma detection rate (ADR) and polyp detection rate (PDR) have been reported in the literature.
Our aim was to perform a meta-analysis to determine the impact of fellow participation during colonoscopy on the ADR and PDR.
Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, pertinent articles that reported ADR and/or PDR between attending physicians alone compared to gastroenterology fellows with attending physicians were obtained through database searches. Data was abstracted and pooled using a random effects model. The quality of each included study was ascertained using a modified version of the Quality Assessment of Diagnostic Accuracy Studies tool, and potential publication bias was assessed.
A total of 14 articles that included 21,504 colonoscopies met the inclusion criteria. The overall PDR and ADR were 44.4 and 30.8%, respectively. No significant differences were found between participant characteristics and colonoscopies performed with or without fellow participation. No significant differences were found in the relative rate of ADR (1.04, 95% CI 0.94-1.15) or PDR (1.03, 95% CI 0.93-1.14) with or without a fellow. An important limitation is that none of the included studies randomized fellow involvement.
Involvement of a fellow during colonoscopy did not affect adenoma and polyp detection rates.
文献中报道了同行在结肠镜检查过程中的参与对腺瘤检出率（ADR）和息肉检出率（PDR）的影响存在矛盾的数据。
我们旨在进行荟萃分析，以确定结肠镜检查中同伴参与对 ADR 和 PDR 的影响。
根据系统评价和荟萃分析的首选报告项目指南，通过数据库搜索获得了单独报告主治医生与主治医生和胃肠病学研究员之间 ADR 和/或 PDR 的相关文章。使用随机效应模型提取和汇总数据。使用诊断准确性研究质量评估工具的修改版本确定每个纳入研究的质量，并评估潜在的发表偏倚。
共有 14 篇文章纳入了 21504 例结肠镜检查，符合纳入标准。总体 PDR 和 ADR 分别为 44.4%和 30.8%。参与者特征和有或没有同伴参与进行的结肠镜检查之间没有发现显著差异。有或没有同伴参与时，ADR 的相对检出率（1.04，95%CI 0.94-1.15）或 PDR（1.03，95%CI 0.93-1.14）无显著差异。一个重要的局限性是，纳入的研究均未对同伴参与进行随机化。
在结肠镜检查中加入同伴并不会影响腺瘤和息肉的检出率。
