Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA; Clinical and Translational Epidemiology Unit, Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
Gastrointest Endosc. 2019 Aug;90(2):254-258.e2. doi: 10.1016/j.gie.2019.03.1172. Epub 2019 Apr 12.
The adenoma detection rate (ADR) is the most important quality metric for colonoscopy. Numerous factors are known to influence ADR. However, no data on the effect of monitor size on ADR exist. The aim of this study was to compare the ADR and polyp detection rate (PDR) achieved using 2 different-size video monitors (19-inch diagonal and 32-inch diagonal).
In a single-center, prospective, randomized clinical trial, endoscopists were randomized on a daily basis to perform routine ambulatory colonoscopies with either a 32-inch diagonal or a 19-inch diagonal video monitor.
The study was conducted between October 2013 and April 2014 in an outpatient center of a tertiary referral hospital. Fifteen endoscopists performed 1795 outpatient colonoscopies (mean age, 55 years; 56% women; screening, 56%). There was no substantial difference in baseline patient characteristics between the 2 arms. The overall ADR (27.4% vs 27.9%; P = .80) and PDR (32.8% vs 34.4%; P = .50) were not significantly different between the 32-inch and 19-inch monitor group, respectively. The findings were not significantly altered when stratified by indication, cecal intubation, bowel preparation, operator experience, and time of endoscopy as well as in a multivariable model that included these variables as potential confounders (all P > .05). Overall, the ADR and PDR for each individual endoscopist did not appear to be influenced by monitor size.
The results of this trial do not support the notion that larger video monitors improve ADR. Future efforts to increase ADR should focus on other aspects of colonoscopy. (Clinical trial registration number: NCT01952418.).
腺瘤检出率（ADR）是结直肠镜检查的最重要的质量指标。许多因素已知会影响 ADR。然而，目前尚无关于显示器尺寸对 ADR 影响的数据。本研究旨在比较使用两种不同尺寸视频显示器（19 英寸对角线和 32 英寸对角线）获得的 ADR 和息肉检出率（PDR）。
在一项单中心、前瞻性、随机临床试验中，内镜医生每天随机使用 32 英寸对角线或 19 英寸对角线视频显示器进行常规门诊结肠镜检查。
该研究于 2013 年 10 月至 2014 年 4 月在一家三级转诊医院的门诊中心进行。15 名内镜医生进行了 1795 例门诊结肠镜检查（平均年龄 55 岁；56%为女性；筛查，56%）。两组患者的基线特征无实质性差异。32 英寸和 19 英寸显示器组的总体 ADR（27.4%与 27.9%；P=0.80）和 PDR（32.8%与 34.4%；P=0.50）均无显著差异。按适应证、盲肠插管、肠道准备、操作者经验和内镜检查时间分层后，以及在包括这些变量作为潜在混杂因素的多变量模型中，结果均无显著差异（均 P>0.05）。总体而言，每位内镜医生的 ADR 和 PDR 似乎不受显示器尺寸的影响。
本试验结果不支持大尺寸视频显示器可提高 ADR 的观点。未来提高 ADR 的努力应集中在结肠镜检查的其他方面。（临床试验注册号：NCT01952418.）。
