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Colonoscope Withdrawal Time Affects Adenoma Detection

Longer mean times detect significantly more neoplasia than shorter times

WEDNESDAY, Dec. 13 (HealthDay News) -- Endoscopists who have longer mean times for withdrawal of the colonoscope detect higher rates of adenomas, according to the results of a study published in the Dec. 14 issue of the New England Journal of Medicine.

Robert L. Barclay, M.D., of the University of Illinois College of Medicine at Rockford, Ill., and colleagues conducted a 15-month study of 12 gastroenterologists who performed 7,882 colonoscopies at a large community-based practice.

The researchers found that gastroenterologists with mean withdrawal times of the recommended six minutes or more had higher rates of detection of any neoplasia (28.3 percent versus 11.8 percent) and of advanced neoplasia (6.4 percent versus 2.6 percent).

"The results of this study are intuitive -- careful endoscopic examination of the colon should improve the rate of detection of adenomas, which is the important indicator of quality," states the author of an accompanying editorial. "Some may argue that measuring quality is onerous and cannot be accomplished efficiently in busy clinical practices. The current study by Barclay et al. shows that the members of a private group practice can 'take a look in the mirror' by asking critical questions about their daily practice and by measuring key outcomes to improve the quality of patient care."

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