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- Harris, JK, et al.
(författare)
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Factors associated with the technical performance of colonoscopy: An EPAGE study.
- 2007
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Ingår i: Digestive and Liver Disease. - : Elsevier BV. - 1590-8658. ; 39:7, s. 678-689
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Tidskriftsartikel (refereegranskat)abstract
- Background Variations in colonoscopy practice exist, which may be related to healthcare quality. Aims To determine factors associated with three performance indicators of colonoscopy: complete colonoscopy, adenomatous polyp diagnosis, and duration. Patients Consecutive patients referred for colonoscopy from 21 centres in 11 countries. Methods This prospective observational study used multiple variable regression analyses to identify determinants of the quality indicators. Results Six thousand and four patients were included in the study. Patients from private, open-access centres (odds ratio: 3.17, 95% confidence interval: 1.87–5.38) were more likely to have a complete colonoscopy than patients from public, gatekeeper centres. Patients from centres where over 50% of the endoscopists were of senior rank were roughly twice as likely to have an adenoma diagnosed, and longer average withdrawal duration (odds ratio: 1.08, 95% confidence interval: 1.07–1.09) was associated with more frequent adenoma diagnoses. Patients who had difficulty during colonoscopy had longer durations to caecum (time ratio: 2.87, 95% confidence interval: 2.72–3.01) and withdrawal durations (time ratio: 1.26, 95% confidence interval: 1.18–1.33) than patients who had no difficulties. Conclusions Multiple factors have been identified as being associated with key quality indicators. The non-modifiable factors permit the identification of patients who may be at greater risk of not having quality colonoscopy, while changes to the modifiable factors may help improve the quality of colonoscopy.
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| 3. |
- Tziatzios, Georgios, et al.
(författare)
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Meta-analysis shows similar re-bleeding rates among Western and Eastern populations after index video capsule endoscopy
- 2018
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Ingår i: Digestive and Liver Disease. - : Elsevier BV. - 1590-8658. ; 50:3, s. 226-239
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Forskningsöversikt (refereegranskat)abstract
- Background & aims: Video capsule endoscopy (VCE) is the first-line diagnostic procedure for investigating obscure gastrointestinal bleeding (OGIB). Different re-bleeding rates following index VCE have been reported among Western and Eastern studies. Methods: We conducted a comprehensive literature search to identify studies examining re-bleeding rates after VCE for OGIB. Meta-analysis assessed the pooled proportion of re-bleeding events after VCE for OGIB according to study's origin (Western vs. Eastern) and according to the length of follow-up (≥24 months vs. <24 months). We also calculated the re-bleeding odds ratios (OR; 95% CI) after positive vs. negative index VCE, overt vs. occult initial presentation of bleeding and after interventional treatment for positive index cases, according to the study's origin. Results: We included 46 (30 Western and 16 Eastern) studies with 5796 patients. Significant heterogeneity was detected among meta-analyzed studies. Overall, the pooled re-bleeding rate was similar between Western (29%; 95% CI: 23-34) and Eastern (21%; 95% CI: 15-27) populations, irrespective of the length of follow-up. The odds of re-bleeding was significantly higher after positive as compared to negative index VCE in Eastern studies (OR: 1.77; 95% CI: 1.07-2.94). Application of specific treatment after positive index VCE was associated with lower re-bleeding odds in both Western (OR: 0.37; 95% CI: 0.16-0.87) and Eastern (OR: 0.39; 95% CI: 0.21-0.72) populations. Conclusions: Patients undergoing VCE for OGIB have similar re-bleeding rates in the East and the West, regardless of the length of follow-up. However, increased re-bleeding odds after positive index VCE is observed in Eastern studies.
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