Then Eric Omar, Brana Christopher, Dadana Sriharsha, Maddika Srikanth, Ofosu Andrew, Brana Sabrina, Wexler Tina, Sunkara Tagore, Culliford Andrea, Gaduputi Vinaya
Division of Gastroenterology and Hepatology, SBH Health System, New York (Eric Omar Then, Christopher Brana, Sriharsha Dadana, Srikanth Maddika, Sabrina Brana, Tina Wexler, Andrea Culliford, Vinaya Gaduputi).
Division of Gastroenterology and Hepatology, The Brooklyn Hospital Center, Clinical Affiliate of The Mount Sinai Hospital, Brooklyn, NY (Andrew Ofosu, Tagore Sunkara), USA.
Ann Gastroenterol. 2020 Jul-Aug;33(4):374-378. doi: 10.20524/aog.2020.0491. Epub 2020 May 10.
Colonoscopy is the gold standard for colon cancer screening. Adenoma detection rate and a withdrawal time of 6 min are quality metrics to measure the efficacy of colonoscopy in colon cancer screening. The aim of our study was to exploit the Hawthorne effect in an effort to ensure adherence to a minimum 6-min withdrawal time and subsequently increase adenoma detection rate.
This was a retrospective single-center study where we reviewed the records of patients who underwent screening colonoscopy in 2015 and 2017. We divided our patient population into 2 groups. The first group of patients from 2015 underwent screening colonoscopy with no visual cues on the colonoscopy monitor. The second group of patients from 2017 had visual cues indicating withdrawal time on the colonoscopy monitor.
Screening colonoscopy had a statistically significantly higher adenoma detection rate when performed with visual cues compared to without visual cues (25.3% vs. 19.45, P=0.04). Polyp detection rate was also higher in the group where visual cueing was used (52.9% vs. 22.9%, P<0.001). There were no statistically significant differences in actual withdrawal time or cecal intubation rates.
Visual cues indicating withdrawal time are a useful intervention that results in an increased adenoma detection rate. Given its practicality and cost effectiveness, we recommend universally implementing visual cues to ensure adherence to a minimum 6-min withdrawal time.
结肠镜检查是结肠癌筛查的金标准。腺瘤检出率和6分钟的退镜时间是衡量结肠镜检查在结肠癌筛查中效果的质量指标。我们研究的目的是利用霍桑效应，以确保遵守至少6分钟的退镜时间，从而提高腺瘤检出率。
这是一项回顾性单中心研究，我们回顾了2015年和2017年接受结肠镜筛查患者的记录。我们将患者群体分为两组。2015年的第一组患者在结肠镜检查时，结肠镜监视器上没有视觉提示。2017年的第二组患者在结肠镜监视器上有显示退镜时间的视觉提示。
与没有视觉提示相比，有视觉提示时进行的结肠镜筛查腺瘤检出率在统计学上显著更高（25.3%对19.45%，P = 0.04）。使用视觉提示的组息肉检出率也更高（52.9%对22.9%，P < 0.001）。实际退镜时间或盲肠插管率没有统计学上的显著差异。
显示退镜时间的视觉提示是一种有用的干预措施，可提高腺瘤检出率。鉴于其实用性和成本效益，我们建议普遍采用视觉提示，以确保遵守至少6分钟的退镜时间。
