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内镜医师人格特质对结肠镜检查中腺瘤和息肉检出率的影响:一项 KASID 多中心研究。

Impact of Endoscopists' Personality Traits on Adenoma and Polyp Detection Rates in Colonoscopy: A KASID Multicenter Study.

机构信息

Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, Republic of Korea.

Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Republic of Korea.

出版信息

Dig Dis Sci. 2020 Aug;65(8):2302-2310. doi: 10.1007/s10620-020-06158-w. Epub 2020 Mar 10.

Abstract

BACKGROUND

The personality traits of endoscopists have been suggested to affect the adenoma detection rate (ADR). We thus evaluated the relationship between endoscopists' personality traits and the ADR during colonoscopy using the Minnesota Multiphasic Personality Inventory-2 (MMPI-2).

METHODS

In total, 1230 patients (asymptomatic and aged 50-80 years) who underwent screening or surveillance (≥ 5 years) colonoscopy were recruited from 13 university hospitals by 20 endoscopists between September 2015 and December 2017. We retrospectively measured the ADR, polyp detection rate (PDR), and number of adenomas per colonoscopy (APC). All 20 endoscopists completed all 567 true/false MMPI-2 items.

RESULTS

The overall mean colonoscopy withdrawal time, PDR, ADR, and APC were 7.3 ± 2.8 min, 55%, 45.3%, and 0.97 ± 1.58, respectively. No significant difference was observed in the MMPI-2 clinical scales (e.g., hypochondriasis and psychasthenia), content scales (e.g., obsessiveness and type A character), or supplementary scales (e.g., dominance and social responsibility) between the high ADR group (ADR ≥45%, n = 10) and the low ADR group (ADR < 45%, n = 10). In multivariate logistic regression analysis, the ADR was associated significantly with patient age and sex. The ADR was related significantly to endoscopists' colonoscopy experience and the per-minute increase in the colonoscopy withdrawal time (OR 1.21, 95% CI 1.06-1.38, p = 0.005). In a logistic regression analysis adjusted for patient factors, the ADR was associated significantly with ego strength (OR 1.04, 95% CI 1.00-1.09, p = 0.044), as measured by the MMPI-2.

CONCLUSIONS

With the exception of ego strength, the endoscopists' personality traits were not associated with adenoma or polyp detection.

摘要

背景

有研究表明,内镜医师的人格特质会影响腺瘤检出率(ADR)。因此,我们使用明尼苏达多相人格测验-2(MMPI-2)评估了内镜医师的人格特质与结肠镜检查中 ADR 之间的关系。

方法

2015 年 9 月至 2017 年 12 月,20 名内镜医师从 13 所大学医院共招募了 1230 名(无症状、年龄 50-80 岁)接受筛查或监测(≥5 年)结肠镜检查的患者。我们回顾性测量了 ADR、息肉检出率(PDR)和每例结肠镜检查检出的腺瘤数(APC)。20 名内镜医师均完成了所有 567 个真/假 MMPI-2 项目。

结果

平均结肠镜检查退镜时间、PDR、ADR 和 APC 分别为 7.3±2.8min、55%、45.3%和 0.97±1.58。高 ADR 组(ADR≥45%,n=10)与低 ADR 组(ADR<45%,n=10)之间,MMPI-2 临床量表(如疑病症和精神衰弱)、内容量表(如强迫观念和 A 型人格)或补充量表(如支配性和社会责任感)均无显著差异。多变量 logistic 回归分析显示,ADR 与患者年龄和性别显著相关。ADR 与内镜医师的结肠镜检查经验以及退镜时间每分钟增加量显著相关(OR 1.21,95%CI 1.06-1.38,p=0.005)。在调整患者因素的 logistic 回归分析中,ADR 与 MMPI-2 测量的自我力量显著相关(OR 1.04,95%CI 1.00-1.09,p=0.044)。

结论

除自我力量外,内镜医师的人格特质与腺瘤或息肉检出率无关。

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