Colonoscopy procedural volume increases adenoma and polyp detection rates in gastroenterologytrainees

Table 2 Adjusted mean polyp-related outcomes, estimated initial status, and changes in outcomes per 100 screening colonoscopies¹ among the entire group of fellows (n = 12)

Outcome1	Overall mean2 (95%CI)	Mean after first 50 colonoscopies (95%CI)	Change in outcome per 100 colonoscopies (95%CI)	P value3	Number of procedures to achieve mean attending value4
ADR (%)	31.5 (28.7-34.3)	25.1 (21.1-29.2)	1.8 (0.8-2.7)	0.002	265
ADR-right (%)	22.3 (20.1-24.4)	15.3 (10.6-20.0)	1.9 (0.7-3.2)	0.01
ADR-left (%)	14.2 (12.4-16.0)	11.6 (8.3-14.9)	0.6 (0.001-1.3)	0.05
PDR (%)	41.9 (37.9-45.9)	31.4 (26.7-36.0)	2.8 (1.7-3.9)	0.0001	292
PDR-right (%)	26.5 (23.8-29.2)	16.0 (10.6-21.4)	2.9 (1.5-4.3)	0.001
PDR-left (%)	24.9 (21.5-28.3)	18.7 (13.1-24.3)	1.6 (0.3-2.9)	0.02
AADR (%)	7.8 (6.6-9.1)	7.4 (4.6-10.2)	0.04 (-0.80-0.90)	0.92
APC	0.58 (0.52-0.65)	0.39 (0.28-0.49)	0.05 (0.03-0.07)	0.0001	399
APC-right	0.37 (0.32-0.42)	0.20 (0.12-0.28)	0.04 (0.02-0.06)	0.001
APC-left	0.22 (0.19-0.25)	0.18 (0.11-0.26)	0.01 (-0.01-0.02)	0.24
PPC	0.84 (0.74-0.94)	0.51(0.36-0.66)	0.09 (0.06-0.12)	< 0.0001	375
PPC-right	0.45 (0.39-0.50)	0.21 (0.11-0.31)	0.06 (0.04-0.09)	< 0.0001
PPC-left	0.40 (0.34-0.46)	0.30 (0.21-0.39)	0.03 (0.01-0.05)	0.01

¹From linear mixed effects regression models, controlling for age, sex, race, and inadequate procedure;

²Mean from all screening colonoscopies over all 3 years of training;

³P value associated with the rate of change;

⁴Mean attending values were: ADR 28.9%, PDR 38.2%, APC 0.57, and PPC 0.80. ADR: Adenoma detection rate; PDR: Polyp detection rate; AADR: Advanced ADR; APC: Mean adenoma per colon; PPC: Mean polyp per colon. Right colon included the cecum, ascending colon, hepatic flexure, and transverse colon. Left colon included splenic flexure, descending colon, sigmoid, and rectum.