PMID- 32240836 OWN - NLM STAT- MEDLINE DCOM- 20210818 LR - 20210818 IS - 1542-7714 (Electronic) IS - 1542-3565 (Linking) VI - 18 IP - 10 DP - 2020 Sep TI - Association Between Endoscopist Annual Procedure Volume and Colonoscopy Quality: Systematic Review and Meta-analysis. PG - 2192-2208.e12 LID - S1542-3565(20)30423-7 [pii] LID - 10.1016/j.cgh.2020.03.046 [doi] AB - BACKGROUND & AIMS: In addition to monitoring adverse events (AEs) and post-colonoscopy colorectal cancers (PCCRC), indicators for assessing colonoscopy quality include adenoma detection rate (ADR) and cecal intubation rate (CIR). It is unclear whether there is an association between annual colonoscopy volume and ADR, CIR, AEs, or PCCRC. METHODS: We searched publication databases through March 2019 for studies assessing the relationship between annual colonoscopy volume and outcomes, including ADR, CIR, AEs, or PCCRC. Pooled odds ratios (ORs) were calculated using DerSimonian and Laird random effects models. Sensitivity analyses were performed to assess for potential methodological or clinical factors associated with outcomes. RESULTS: We performed a systematic review of 9235 initial citations, generating 27 retained studies comprising 11,276,244 colonoscopies. There was no association between procedural volume and ADR (OR, 1.00; 95% CI, 0.98-1.02 per additional 100 annual procedures). CIR improved with each additional 100 annual procedures (OR, 1.17; 95% CI, 1.08-1.28). There was a non-significant trend toward decreased overall AEs per additional 100 annual procedures (OR, 0.95; 95% CI, 0.90-1.00). There was considerable heterogeneity among most analyses. CONCLUSIONS: In a systematic review and meta-analysis, we found higher annual colonoscopy volumes to correlate with higher CIR, but not with ADR or PCCRC. Trends toward fewer AEs were associated with higher annual colonoscopy volumes. There are few data available from endoscopists who perform fewer than 100 annual colonoscopies. Studies are needed on extremes in performance volumes to more clearly elucidate associations between colonoscopy volumes and outcomes. CI - Copyright (c) 2020 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Forbes, Nauzer AU - Forbes N AD - Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta; Forzani & MacPhail Colon Cancer Screening Centre, Alberta Health Services, Calgary, Alberta. FAU - Boyne, Devon J AU - Boyne DJ AD - Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta; Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Calgary, Alberta. FAU - Mazurek, Matthew S AU - Mazurek MS AD - Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta. FAU - Hilsden, Robert J AU - Hilsden RJ AD - Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta; Forzani & MacPhail Colon Cancer Screening Centre, Alberta Health Services, Calgary, Alberta; Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Calgary, Alberta. FAU - Sutherland, R Liam AU - Sutherland RL AD - Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta. FAU - Pader, Joy AU - Pader J AD - Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Calgary, Alberta. FAU - Ruan, Yibing AU - Ruan Y AD - Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Calgary, Alberta; Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta. FAU - Shaheen, Abdel Aziz AU - Shaheen AA AD - Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta. FAU - Wong, Clarence AU - Wong C AD - Department of Medicine, University of Alberta, Edmonton, Alberta. FAU - Lamidi, Mubasiru AU - Lamidi M AD - Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta; Forzani & MacPhail Colon Cancer Screening Centre, Alberta Health Services, Calgary, Alberta. FAU - Lorenzetti, Diane L AU - Lorenzetti DL AD - Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta; Health Sciences Library, University of Calgary, Calgary, Alberta, Canada. FAU - Brenner, Darren R AU - Brenner DR AD - Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta; Forzani & MacPhail Colon Cancer Screening Centre, Alberta Health Services, Calgary, Alberta; Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Calgary, Alberta; Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta. FAU - Heitman, Steven J AU - Heitman SJ AD - Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta; Forzani & MacPhail Colon Cancer Screening Centre, Alberta Health Services, Calgary, Alberta. Electronic address: steven.heitman@ucalgary.ca. LA - eng PT - Journal Article PT - Meta-Analysis PT - Research Support, Non-U.S. Gov't PT - Systematic Review DEP - 20200330 PL - United States TA - Clin Gastroenterol Hepatol JT - Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association JID - 101160775 SB - IM MH - *Adenoma/diagnosis MH - Cecum MH - Colonoscopy MH - *Colorectal Neoplasms MH - Early Detection of Cancer MH - Humans OTO - NOTNLM OT - Competency OT - Complication OT - Neoplasm OT - Polyp EDAT- 2020/04/03 06:00 MHDA- 2021/08/19 06:00 CRDT- 2020/04/03 06:00 PHST- 2020/02/24 00:00 [received] PHST- 2020/03/02 00:00 [accepted] PHST- 2020/04/03 06:00 [pubmed] PHST- 2021/08/19 06:00 [medline] PHST- 2020/04/03 06:00 [entrez] AID - S1542-3565(20)30423-7 [pii] AID - 10.1016/j.cgh.2020.03.046 [doi] PST - ppublish SO - Clin Gastroenterol Hepatol. 2020 Sep;18(10):2192-2208.e12. doi: 10.1016/j.cgh.2020.03.046. Epub 2020 Mar 30.