P2359 - Implementation of an Educational Intervention for Colonoscopists Increases Serrated Polyps Detection Rates

Tuesday, October 26, 2021

10:30 AM – 4:00 PM PT

Location: Shoreline Exhibit Hall

Has Audio

Presenting Author(s)

ZP

Zoe Post, MD

Rush University Medical Center
Chicago, IL, United States

Zoe Post, MD¹, Agnieszka M. Maniak, MD¹, Muhammad Alsayid, MD¹, Daniel Berger, MD², Joshua E. Melson, MD, MPH¹
¹Rush University Medical Center, Chicago, IL; ²Mount Sinai Hospital, Chicago, IL

Introduction: Serrated polyps (SP) are frequently missed during colonoscopy as their endoscopic features are difficult to identify due to a variety of factors. They are thought to be over-represented in interval colorectal cancers (CRC). This study evaluates the effectiveness of an online learning module on SP detection rates.

Methods: This prospective cohort study analyzed colonoscopies performed by two groups of endoscopists at a single tertiary institution between 2017-2018. The intervention consisted of an online learning module developed by the Amsterdam University Medical Center, consisting of three 5-to-25-minute videos focusing on the Workgroup Serrated Polyps and Polyposis (WASP) classification that was developed by the Dutch Workgroup with the aim to differentiate sessile SP from adenomas and hyperplastic polyps (HP). A total of eleven colonoscopists participated in the study: six colonoscopists were randomly selected to complete the online learning module and five colonoscopists formed the control group. The pre-intervention time period lasted from September until December 2017, while the post-intervention time period included data from January until August of 2018. Electronic medical records of patients were reviewed and colonoscopy data was retrieved. The primary outcome was the SP detection rate and the secondary outcome was the detection rate of SP > 10mm.

Results: A total of 1943 colonoscopies were included in the study. The control group performed a total of 494 colonoscopies. The intervention group performed 272 colonoscopies pre-intervention and 1177 colonoscopies post-intervention. Figure 1 shows the detection rate of any SP in each group. The control group and the pre-intervention group had similar SP detection rates (12.9% vs. 13.6%, P=0.8). The SP detection rate was significantly higher post-intervention as compared to the control group (18.6% vs. 12.9%, P< 0.01). The detection rate of SPs > 10mm was significantly higher in the post-intervention group as compared to the control group (2.1% vs. 0.4%, P=0.01).

Discussion: Our pilot study shows that a simple E-learning module including WASP criteria can improve SP detection rates. The study was limited due to small sample size. Whether improving the learning module will benefit SP detection rates is unclear, but is worth investigating based on these promising results.

Group	Total number of colonoscopies	Any SP detection rate absolute no. (%)	SP > 10 mm detection rate absolute no. (%)
Pre-intervention	272	37 (13.6%)	2 (0.74%)
Post-intervention	1177	219 (18.61%)	25 (2.12%)
Control	494	64 (12.96%)	2 (0.4%)

Table: Table 1. Overview of serrated polyp detection rate. The absolute number of the detection rate represents the total number of colonoscopies during which a SP was detected, while the percentage represents the percentage of colonoscopies in this group that found a SP. ‘Any SP’ is defined as any serrated polyp, including right-sided hyperplastic polyps, sessile serrated lesions (SSL), traditional serrated adenomas (TSA), SP > 10mm and SP with dysplasia. SP > 10 mm is defined as any SP that appears larger than 10mm in size on endoscopic evaluation.

Disclosures:

Zoe Post indicated no relevant financial relationships.

Agnieszka Maniak indicated no relevant financial relationships.

Muhammad Alsayid indicated no relevant financial relationships.

Daniel Berger indicated no relevant financial relationships.

Joshua Melson indicated no relevant financial relationships.

Zoe Post, MD¹, Agnieszka M. Maniak, MD¹, Muhammad Alsayid, MD¹, Daniel Berger, MD², Joshua E. Melson, MD, MPH¹. P2359 - Implementation of an Educational Intervention for Colonoscopists Increases Serrated Polyps Detection Rates, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.