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Leadership training to improve adenoma detection rate in screening colonoscopy: a randomised trial

Gut, 2016-04, Vol.65 (4), p.616-624 [Peer Reviewed Journal]

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing ;Copyright: 2016 Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing ;Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ 2016 ;ISSN: 0017-5749 ;EISSN: 1468-3288 ;DOI: 10.1136/gutjnl-2014-307503 ;PMID: 25670810 ;CODEN: GUTTAK

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  • Title:
    Leadership training to improve adenoma detection rate in screening colonoscopy: a randomised trial
  • Author: Kaminski, Michal F ; Anderson, John ; Valori, Roland ; Kraszewska, Ewa ; Rupinski, Maciej ; Pachlewski, Jacek ; Wronska, Ewa ; Bretthauer, Michael ; Thomas-Gibson, Siwan ; Kuipers, Ernst J ; Regula, Jaroslaw
  • Subjects: Adenoma - diagnosis ; Audits ; Colonoscopy - education ; Colorectal cancer ; Colorectal Neoplasms - diagnosis ; Early Detection of Cancer ; Endoscopy ; Feedback ; Female ; Humans ; Intervention ; Leadership ; Male ; Mass Screening ; Medical screening ; Poland ; Quality Improvement ; Single-Blind Method ; Studies ; Tumors
  • Is Part Of: Gut, 2016-04, Vol.65 (4), p.616-624
  • Description: ObjectiveSuboptimal adenoma detection rate (ADR) at colonoscopy is associated with increased risk of interval colorectal cancer. It is uncertain how ADR might be improved. We compared the effect of leadership training versus feedback only on colonoscopy quality in a countrywide randomised trial.Design40 colonoscopy screening centres with suboptimal performance in the Polish screening programme (centre leader ADR ≤25% during preintervention phase January to December 2011) were randomised to either a Train-Colonoscopy-Leaders (TCLs) programme (assessment, hands-on training, post-training feedback) or feedback only (individual quality measures). Colonoscopies performed June to December 2012 (early postintervention) and January to December 2013 (late postintervention) were used to calculate changes in quality measures. Primary outcome was change in leaders’ ADR. Mixed effect models using ORs and 95% CIs were computed.ResultsThe study included 24 582 colonoscopies performed by 38 leaders and 56 617 colonoscopies performed by 138 endoscopists at the participating centres. The absolute difference between the TCL and feedback groups in mean ADR improvement of leaders was 7.1% and 4.2% in early and late postintervention phases, respectively. The TCL group had larger improvement in ADR in early (OR 1.61; 95% CI 1.29 to 2.01; p<0.001) and late (OR 1.35; 95% CI 1.10 to 1.66; p=0.004) postintervention phases. In the late postintervention phase, the absolute difference between the TCL and feedback groups in mean ADR improvement of entire centres was 3.9% (OR 1.25; 95% CI 1.04 to 1.50; p=0.017).ConclusionsTeaching centre leaders in colonoscopy training improved important quality measures in screening colonoscopy.Trial registration numberNCT01667198.
  • Publisher: England: BMJ Publishing Group LTD
  • Language: English
  • Identifier: ISSN: 0017-5749
    EISSN: 1468-3288
    DOI: 10.1136/gutjnl-2014-307503
    PMID: 25670810
    CODEN: GUTTAK
  • Source: BMJ Open Access Journals
    MEDLINE
    ProQuest Central
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