TOPLINE:
validating the SSLDR as a clinically relevant quality measure.
METHODOLOGY:
- An analysis of the association between PCCRC and SSLDR was conducted using data from the New Hampshire Colonoscopy Registry.
- The cohort included patients who had either a colonoscopy or a diagnosis of CRC.
- The outcome was PCCRC (that is, CRC diagnosed at least 6 months after index colonoscopy).
- The exposure of interest was endoscopist-specific SSLDR.
TAKEAWAY:
- Of 26,901 patients, 162 were diagnosed with PCCRC.
- Endoscopists with a higher SSLDR had lower unadjusted risks for PCCRC (0.3% among those with an SSLDR of at least 6.0% (hazard ratio, 0.29).
- There was a significant 14% reduction in PCCRC for each 1% increase in SSLDR (HR, 0.86).
- Roughly one-third of endoscopists had an adequate adenoma detection rate yet had an SSLDR that was less than the most protective SSLDR of 6%.
IN PRACTICE:
“Endoscopists should strive to achieve the highest SSLDR rate, perhaps with the use of artificial intelligence,” the authors wrote. “Our data linking low SSLDR to increased PCCRC support development of recommendations to measure SDR [serrated detection rates] in clinical practice, and development of educational platforms, techniques and devices to improve low SDR.”
SOURCE:
The study was led by Joseph C. Anderson, MD, with the Geisel School of Medicine at Dartmouth, Hanover, N.H. It was published online in the American Journal of Gastroenterology. The study had no commercial funding.
LIMITATIONS:
The study population came from New Hampshire, which lacks racial diversity. There may be differences in serrated polyp detection in other populations with more high-risk groups, such as smokers. There may be significant variation in SSLDR because of variation in pathological interpretation.
DISCLOSURES:
The authors reported no relevant financial conflicts of interest.
A version of this article first appeared on Medscape.com.