ASGE Masterclass: Colonoscopy (On-Demand) | January 2022-5_Shaukat

5_Shaukat_Improving ADR

Pdf Summary

The document discusses the importance of maximizing the Adenoma Detection Rate (ADR) in colonoscopies as a quality metric. The ADR is the percentage of screening colonoscopies that result in the detection of one or more adenomas. The benchmark for ADR is 25%, with higher benchmarks for specific populations. Studies have shown that each 1% increase in ADR is associated with a 3% decrease in the risk of colorectal cancer (CRC) and a 5% decrease in the risk of fatal CRC. Therefore, improving ADR is crucial for reducing the risk of interval cancer and fatal CRC.<br /><br />The document suggests several interventions to improve ADR. The first step is to measure and report quality indicators, providing physicians with report cards that compare their ADR to benchmarks. Techniques such as withdrawal time, complete resection of polyps, and polyp recognition are important factors in improving ADR. Training programs, use of accessory devices, and emerging technologies like artificial intelligence (AI) can also be utilized to enhance ADR.<br /><br />Moreover, multifaceted interventions are needed to achieve higher ADRs. Video recording and feedback, AI assistance, and educational programs can all contribute to improving ADR. These interventions require effort and cost, but they have shown positive results in various studies.<br /><br />In summary, maximizing ADR is crucial for improving the effectiveness of colonoscopies in detecting adenomas and reducing the risk of colorectal cancer. This can be achieved through a combination of techniques, technologies, and educational programs. Tracking and reporting ADR is essential for monitoring and improving the quality of colonoscopies.

Keywords

Adenoma Detection Rate

colonoscopies

screening

benchmark

colorectal cancer

fatal CRC

interventions

withdrawal time

polyp recognition

artificial intelligence