If You Have a Low Adenoma Detection Rate, Don’t Blame Your Fellows

Excerpt

Quality measures in colonoscopy are at the forefront in the field of gastroenterology, particularly in light of the current emphasis on “accountable” care. Colonoscopy quality measures include cecal intubation rate, complication rate, adenoma detection rate (ADR), and appropriate screening and surveillance intervals. For screening and surveillance colonoscopy, ADR is emerging as perhaps the most important quality indicator, since identification and removal of adenomas is the primary goal. Factors that improve ADR include adequacy of bowel preparation, cecal withdrawal time, time of day that colonoscopy is performed, type of sedation regimen used, and use of techniques such as cap-assisted colonoscopy and retroflexion in the right colon [1, 2]. …