title: Comparison of adenoma detection rate and adenoma per colonoscopy as a quality indicator of colonoscopy.
abstract: BACKGROUND
  Although adenoma detection rate (ADR) has been proposed as a quality indicator of colonoscopies, adenomas per colonoscopy (APC) is a promising alternative to ADR, as it reflects inspection over the entire length of the colon. This study investigated the correlation between ADR and APC, and compared the efficacy of ADR and APC based on the correlation of each with the advanced adenoma detection rate (AADR).
  
  
  METHODS
  Two prospectively collected databases, including the 1142 subjects who underwent screening colonoscopies by 28 colonoscopists, were retrospectively reviewed. AADR1 were definded as the proportion of participants having advanced neoplasms, and AADR2 were definded as the proportion of participants having advanced neoplasms or three or more adenomas. Pearson correlation and Steiger's z-test was used to evaluate the relationship between ADR-APC, ADR-AADR and APC-AADR.
  
  
  RESULTS
  The ADRs ranged from 16.67 to 66.67% (mean, 37.29%) and APCs ranged from 0.22 to 1.28 (mean, 0.65). The ADR and APC showed a significant correlation (R = 0.82; p < 0.001). The screening ADR was significantly correlated with AADR1/AADR2 (R = 0.60; p = 0.001 and R = 0.64; p < 0.001, respectively). APC was also significantly correlated with AADR1/AADR2 (R = 0.65; p < 0.001 and R = 0.77; p < 0.001, respectively). The correlation coefficient for APC-AADR2 was higher than ADR-AADR2 (0.77 versus 0.64, p = 0.04).
  
  
  CONCLUSIONS
  Colonoscopists' ADRs and APC were significantly correlated. Moreover, as the correlation coefficient for AADR was higher with APC than it was with ADR, APC might be a better quality indicator of colonoscopy than ADR.
authors.affiliation: a Division of Gastroenterology, Department of Internal Medicine , Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine , Seoul , Korea ;
authors.forename: Soo-Kyung
authors.initials: SK
authors.lastname: Park
authors.affiliation: a Division of Gastroenterology, Department of Internal Medicine , Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine , Seoul , Korea ;
authors.forename: Hyun-Young
authors.initials: HY
authors.lastname: Kim
authors.affiliation: b Department of Internal Medicine , Kyung Hee University School of Medicine , Seoul , Korea ;
authors.forename: Chang Kyun
authors.initials: CK
authors.lastname: Lee
authors.affiliation: b Department of Internal Medicine , Kyung Hee University School of Medicine , Seoul , Korea ;
authors.forename: Jae Myung
authors.initials: JM
authors.lastname: Cha
authors.affiliation: c Department of Internal Medicine , Hanyang University Guri Hospital , Guri , Korea ;
authors.forename: Chang Soo
authors.initials: CS
authors.lastname: Eun
authors.affiliation: c Department of Internal Medicine , Hanyang University Guri Hospital , Guri , Korea ;
authors.forename: Dong Soo
authors.initials: DS
authors.lastname: Han
authors.affiliation: d Department of Internal Medicine , Catholic University School of Medicine , Seoul , Korea ;
authors.forename: Bo-In
authors.initials: BI
authors.lastname: Lee
authors.affiliation: e Department of Internal Medicine , Dankook University School of Medicine , Chonan , Korea.
authors.forename: Jeong Eun
authors.initials: JE
authors.lastname: Shin
authors.affiliation: a Division of Gastroenterology, Department of Internal Medicine , Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine , Seoul , Korea ;
authors.forename: Dong Il
authors.initials: DI
authors.lastname: Park
mesh_terms: D000236:Adenoma / Q000175:diagnosis* / Q000473:pathology; D003110:Colonic Neoplasms / Q000175:diagnosis*; D003113:Colonoscopy / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019984:Quality Indicators, Health Care; D012189:Retrospective Studies
keywords: Adenoma; colonoscopy; screening