RT Journal Article
SR Electronic
T1 Leadership training to improve adenoma detection rate in screening colonoscopy: a randomised trial
JF Gut
JO Gut
FD BMJ Publishing Group Ltd and British Society of Gastroenterology
SP 616
OP 624
DO 10.1136/gutjnl-2014-307503
VO 65
IS 4
A1 Kaminski, Michal F
A1 Anderson, John
A1 Valori, Roland
A1 Kraszewska, Ewa
A1 Rupinski, Maciej
A1 Pachlewski, Jacek
A1 Wronska, Ewa
A1 Bretthauer, Michael
A1 Thomas-Gibson, Siwan
A1 Kuipers, Ernst J
A1 Regula, Jaroslaw
YR 2016
UL http://gut.bmj.com/content/65/4/616.abstract
AB Objective Suboptimal 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.Design 40 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.Results The 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).Conclusions Teaching centre leaders in colonoscopy training improved important quality measures in screening colonoscopy.Trial registration number NCT01667198.