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Participation of Fellow in Colonoscopies Boosts Detection

When GI fellows participate, detection of adenomas and polyps, but not cancers, is increased

THURSDAY, May 6 (HealthDay News) -- When gastrointestinal (GI) fellows -- especially third-year fellows -- are involved in the performance of routine screening colonoscopies, the detection rates for adenomas and polyps are increased, according to a study in the May issue of Clinical Gastroenterology and Hepatology.

Stevany L. Peters, M.D., of the University of Colorado Denver in Aurora, and colleagues reviewed all average-risk screening colonoscopies performed during April 2005 to April 2007 at the University of Colorado Hospital by either a gastroenterologist alone or by a GI fellow supervised by a physician.

The researchers found the adenoma detection rate (ADR) and polyp detection rate were both significantly higher for colonoscopies in which a fellow participated compared to those performed by a gastroenterologist alone (odds ratios [ORs], 1.32 and 1.28, respectively). However, they found no difference in the detection of advanced adenomas or cancers (OR, 1.05). Further, the ADR increased with each year of fellow training (OR, 0.89 for first-year fellows; OR, 1.31 for second-year fellows; and OR, 1.70 for third-year fellows).

"In conclusion, this study has shown that GI fellow involvement is associated with increased polyp and adenoma detection during screening colonoscopies. Furthermore, the level of fellow training clearly impacts detection rates, with higher rates associated with third-year fellow participation. This study suggests that in addition to technological advances to improve field of view and imaging, the addition of a trained second observer might greatly improve ADRs," the authors write.

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