title: Variation in polyp size estimation among endoscopists and impact on surveillance intervals.
abstract: BACKGROUND
  Accurate estimation of polyp size is important because it is used to determine the surveillance interval after polypectomy.
  
  
  OBJECTIVE
  To evaluate the variation and accuracy in polyp size estimation among endoscopists and the impact on surveillance intervals after polypectomy.
  
  
  METHODS
  Web-based survey.
  
  
  METHODS
  A total of 873 members of the American Society for Gastrointestinal Endoscopy.
  
  
  METHODS
  Participants watched video recordings of 4 polypectomies and were asked to estimate the polyp sizes.
  
  
  METHODS
  Proportion of participants with polyp size estimates within 20% of the correct measurement and the frequency of incorrect surveillance intervals based on inaccurate size estimates.
  
  
  RESULTS
  Polyp size estimates were within 20% of the correct value for 1362 (48%) of 2812 estimates (range 39%-59% for the 4 polyps). Polyp size was overestimated by >20% in 889 estimates (32%, range 15%-49%) and underestimated by >20% in 561 (20%, range 4%-46%) estimates. Incorrect surveillance intervals because of overestimation or underestimation occurred in 272 (10%) of the 2812 estimates (range 5%-14%). Participants in a private practice setting overestimated the size of 3 or of all 4 polyps by >20% more often than participants in an academic setting (difference = 7%; 95% confidence interval, 1%-11%).
  
  
  CONCLUSIONS
  Survey design with the use of video clips.
  
  
  CONCLUSIONS
  Substantial overestimation and underestimation of polyp size occurs with visual estimation leading to incorrect surveillance intervals in 10% of cases. Our findings support routine use of measurement tools to improve polyp size estimates.
authors.affiliation: Section of Digestive Diseases, Yale University School of Medicine, New Haven, Connecticut, USA.
authors.forename: Louis
authors.initials: L
authors.lastname: Chaptini
authors.affiliation: Division of Gastroenterology and Liver Diseases, Cooper Medical School of Rowan University, Cooper University Healthcare, Camden, New Jersey, USA.
authors.forename: Adib
authors.initials: A
authors.lastname: Chaaya
authors.affiliation: Division of Gastroenterology and Liver Diseases, Cooper Medical School of Rowan University, Cooper University Healthcare, Camden, New Jersey, USA.
authors.forename: Fedele
authors.initials: F
authors.lastname: Depalma
authors.affiliation: Division of Gastroenterology and Liver Diseases, Cooper Medical School of Rowan University, Cooper University Healthcare, Camden, New Jersey, USA.
authors.forename: Krystal
authors.initials: K
authors.lastname: Hunter
authors.affiliation: Division of Gastroenterology and Liver Diseases, Cooper Medical School of Rowan University, Cooper University Healthcare, Camden, New Jersey, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Peikin
authors.affiliation: Section of Digestive Diseases, Yale University School of Medicine, New Haven, Connecticut, USA; VA Connecticut Healthcare System, West Haven, Connecticut, USA.
authors.forename: Loren
authors.initials: L
authors.lastname: Laine
mesh_terms: D002983:Clinical Competence; D003111:Colonic Polyps / Q000175:diagnosis / Q000473:pathology*; D003113:Colonoscopy / Q000592:standards* / Q000639:trends; D016001:Confidence Intervals; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D020407:Internet; D008297:Male; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012955:Societies, Medical; D014481:United States; D014741:Video Recording