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Gastrointest Endosc. 2018 Mar;87(3):778-786.e5. doi: 10.1016/j.gie.2017.08.023. Epub 2017 Sep 1.

Physician characteristics associated with higher adenoma detection rate.

Author information

1
Harvard Medical School, Boston, Massachusetts, USA; Division of General Internal Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
2
Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
3
Harvard Medical School, Boston, Massachusetts, USA.
4
Kaiser Permanente of Washington Health Research Institute (formerly Group Health Research Institute), Seattle, Washington, USA.
5
Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
6
Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
7
Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.

Abstract

BACKGROUND AND AIMS:

Patients who receive a colonoscopy from a physician with a low adenoma detection rate (ADR) are at higher risk of subsequent colorectal cancer. It is unclear what drives the variation across physicians in ADR. We describe physician characteristics associated with higher ADR.

METHODS:

In this retrospective cohort study a natural language processing system was used to analyze all outpatient colonoscopy examinations and their associated pathology reports from October 2013 to September 2015 for adults age 40 years and older across physicians from 4 diverse health systems. Physician performance on ADR was risk adjusted for differences in patient population and procedure indication. Our sample included 201 physicians performing at least 30 colonoscopy examinations during the study period, totaling 104,618 colonoscopy examinations.

RESULTS:

The mean ADR was 33.2% (range, 6.3%-58.7%). Higher ADR was seen among female physicians (4.2 percentage points higher than men, P = .020), gastroenterologists (9.4 percentage points higher than nongastroenterologists, P < .001), and physicians with ≤9 years since their residency completion (6.0 percentage points higher than physicians who have had 27-51 years of practice, P = .004).

CONCLUSIONS:

Gastroenterologists, female physicians, and more recently trained physicians had higher performance in adenoma detection.

PMID:
28866456
PMCID:
PMC5817032
DOI:
10.1016/j.gie.2017.08.023
[Indexed for MEDLINE]
Free PMC Article

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