Effect of Real-time Visual Feedback on Adenoma Detection Rate
Anita Saini, Pradeep Bekal, Alan V. Safdi, Daniel Walker, Bharat Saini, Manish Chokshi, Michael A. Safdi · The American Journal of Gastroenterology · 2009
Purpose: One of the quality indicators for colonoscopy is detection of adenomas: among healthy asymptomatic patients undergoing screening colonoscopy, adenomas should be detected in >25% of men and >15% women more than 50 years old. The purpose of this study is to assess whether adenoma detection rate improves by providing real-time visual feedback using computer automation during colonoscopy. Methods: eMergeEndo is an automated workflow system which is used for intra-operative documentation of procedures. eMergeEndo measures and provides quality indicators data in real-time. During colonoscopy, withdrawal time is displayed live in bold numbers giving endoscopists visual feedback. Live display of withdrawal time was introduced in June 2008. We have documented in a previous study that eMergeEndo improved colonoscopy withdrawal times by providing real-time visual feedback to endoscopists. We are now evaluating if adenoma detection rate improves with improved withdrawal times. We retrospectively analyzed data for adenoma detection rate in screening colonoscopies, at one endoscopy center, for 15 physicians over 5 month time periods before and after implementation of eMergeEndo. Results: As seen in the table, adenoma detection rates improved from 26.6% to 31.8% (p-value 0.259) in men and from 19.8% to 28.7% (p-value 0.0248) in women after real-time visual feedback for colonoscopy withdrawal times was provided to endoscopists. Although p-value is not statistically significant in men, there is a trend towards improvement in adenoma detection rate. This study shows a statistically significant p-value for adenoma detection rate in women. Conclusion: Our analysis shows that by giving endoscopists access to realtime and visual quality data results in improved adenoma detection rate in screening colonoscopies. Disclosure: - Pradeep Bekal M.D. (co-author) is co-inventor and co-founder of eMergeEndo - Alan Safdi, M.D. (co-author) is co-inventor and co-founder of eMergeEndo - Daniel Walker (co-author) is co-inventor and co-founder of eMergeEndo - Bharat Saini (co-author and spouse of presenter) is co-inventor and co-founder of eMergeEndo - Manish Chokshi, M.D. (co-author) is co-inventor and co-founder of eMergeEndo - Michael Safdi, M.D., FACP, FACG (co-author) is co-inventor and co-founder of eMergeEndo.Table