title: Trainees' adenoma detection rate is higher if ≥ 10 minutes is spent on withdrawal during colonoscopy.
abstract: BACKGROUND
  It has been demonstrated that prolonged colonoscopic withdrawal times (WT; >6 min) are beneficial for the adenoma detection rate (ADR) for experienced endoscopists. There are little data, however, to guide the appropriate colonoscopic withdrawal times for trainees. The purpose of this study was to determine whether there is a relationship between WTs and ADR for first-year fellows training in colonoscopy.
  
  
  METHODS
  This is a prospective study of first-year gastroenterology fellows at a single academic teaching hospital who documented each colonoscopy with a self-report form over the course of an academic year (March 2010 to February 2011). The internal policy for the trainees was to have at least a 6-min withdrawal time for each colonoscopy.
  
  
  RESULTS
  Four first-year fellows in gastroenterology at an academic medical center completed self-reports for 1,210 colonoscopies. Mean WT was 10.2 ± 3.4 min. The aggregate polyp detection rate was 33.2% and the aggregate ADR was 22.3%. For colonoscopies with WT < 10 min, ADR was 9.5%, and for colonoscopies with WT ≥ 10 min, ADR was 32.3% (p < 0.001). When the quality indicator of 25% goal ADR for males and 15% goal ADR for females is applied, this aggregate rate is achieved for both sexes for screening colonoscopies (n = 676) with WT ≥ 10 min.
  
  
  CONCLUSIONS
  First-year trainees had a significantly higher ADR if their colonoscopic WT is ≥ 10 min.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Gromski
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Miller
authors.forename: Suck-Ho
authors.initials: SH
authors.lastname: Lee
authors.forename: Eun Seo
authors.initials: ES
authors.lastname: Park
authors.forename: Tae Hoon
authors.initials: TH
authors.lastname: Lee
authors.forename: Sang-Heum
authors.initials: SH
authors.lastname: Park
authors.forename: Il-Kwun
authors.initials: IK
authors.lastname: Chung
authors.forename: Sun-Joo
authors.initials: SJ
authors.lastname: Kim
authors.forename: Young
authors.initials: Y
authors.lastname: Hwangbo
mesh_terms: D000236:Adenoma / Q000175:diagnosis*; D000368:Aged; D002983:Clinical Competence / Q000592:standards*; D003110:Colonic Neoplasms / Q000175:diagnosis*; D003113:Colonoscopy / Q000193:education / Q000592:standards*; D055088:Early Detection of Cancer; D004503:Education, Medical, Graduate; D005260:Female; D005762:Gastroenterology / Q000193:education*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors
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