title: Optical diagnosis of colorectal neoplasia: A Western perspective.
abstract: Optical diagnosis is an emerging paradigm in Western endoscopic practice for the colonoscopic management of diminutive polyps, and includes two complementary clinical strategies: 'resect and discard', in which diminutive high-confidence adenomas are identified, and then removed and discarded without pathological assessment; and 'diagnose and leave', where diminutive high-confidence hyperplastic polyps are identified in the rectosigmoid and then left without resection or biopsy. Like other aspects of colonoscopy performance, adoption of optical diagnosis in Western practice is limited by operator dependency and variation in clinical effectiveness. There is substantial potential for optical diagnosis of colorectal neoplasia during colonoscopy to alleviate the rising costs of health care in the West. However, operator dependence in diagnostic performance together with critical system factors such as informed consent, credentialing, medical legal support and reimbursement incentives must be overcome before optical diagnosis of diminutive lesions is considered for widespread adoption in Western clinical practice.
authors: School of Medicine, The University of Queensland, Brisbane, Australia.|Division of Gastroenterology, Queen Elizabeth II Jubilee Hospital, Brisbane, Australia.
authors: Shinichiro
authors: S
authors: Sakata
authors: Division of Gastroenterology, Queen Elizabeth II Jubilee Hospital, Brisbane, Australia.
authors: Ammar O
authors: AO
authors: Kheir
authors: School of Medicine, The University of Queensland, Brisbane, Australia.|Division of Gastroenterology, Queen Elizabeth II Jubilee Hospital, Brisbane, Australia.
authors: David G
authors: DG
authors: Hewett
mesh_terms: D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging*; D006801:Humans; D007089:Image Enhancement
keywords: adenoma; colonoscopy; cost savings; health-care reform; narrow band imaging