Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/16371
Full metadata record
DC FieldValueLanguage
dc.contributor.authorChandran, Sujievvan-
dc.contributor.authorParker, F-
dc.contributor.authorLontos, Steve-
dc.contributor.authorVaughan, Rhys B-
dc.contributor.authorEfthymiou, Marios-
dc.date2015-12-09-
dc.date.accessioned2016-10-18T03:13:28Z-
dc.date.available2016-10-18T03:13:28Z-
dc.date.issued2015-12-
dc.identifier.citationInternal Medicine Journal 2015; 45(12): 1293-1299en_US
dc.identifier.urihttps://ahro.austin.org.au/austinjspui/handle/1/16371-
dc.description.abstractBACKGROUND: Polyps identified at colonoscopy are predominantly diminutive (<5 mm) with a small risk (>1%) of high-grade dysplasia or carcinoma; however, the cost of histological assessment is substantial. AIM: The aim of this study was to determine whether prediction of colonoscopy surveillance intervals based on real-time endoscopic assessment of polyp histology is accurate and cost effective. METHODS: A prospective cohort study was conducted across a tertiary care and private community hospital. Ninety-four patients underwent colonoscopy and polypectomy of diminutive (≤5 mm) polyps from October 2012 to July 2013, yielding a total of 159 polyps. Polyps were examined and classified according to the Sano-Emura classification system. The endoscopic assessment (optical diagnosis) of polyp histology was used to predict appropriate colonoscopy surveillance intervals. The main outcome measure was the accuracy of optical diagnosis of diminutive colonic polyps against the gold standard of histological assessment. RESULTS: Optical diagnosis was correct in 105/108 (97.2%) adenomas. This yielded a sensitivity, specificity and positive and negative predictive values (with 95%CI) of 97.2% (92.1-99.4%), 78.4% (64.7-88.7%), 90.5% (83.7-95.2%) and 93% (80.9-98.5%) respectively. Ninety-two (98%) patients were correctly triaged to their repeat surveillance colonoscopy. Based on these findings, a cut and discard approach would have resulted in a saving of $319.77 per patient. CONCLUSION: Endoscopists within a tertiary care setting can accurately predict diminutive polyp histology and confer an appropriate surveillance interval with an associated financial benefit to the healthcare system. However, limitations to its application in the community setting exist, which may improve with further training and high-definition colonoscopes.en_US
dc.subjectColonic Neoplasmen_US
dc.subjectColonoscopyen_US
dc.subjectCost-benefit analysisen_US
dc.subjectHistologyen_US
dc.subjectPolypsen_US
dc.titleCan we ease the financial burden of colonoscopy? Using real-time endoscopic assessment of polyp histology to predict surveillance intervalsen_US
dc.typeJournal Articleen_US
dc.identifier.journaltitleInternal Medicine Journalen_US
dc.identifier.affiliationGastroenterology and Hepatologyen_US
dc.identifier.affiliationAnaesthesiaen_US
dc.identifier.affiliationDepartment of Gastroenterology, Warringal Private Hospital, Heidelberg, Victoria, Australiaen_US
dc.identifier.pubmedurihttps://pubmed.ncbi.nlm.nih.gov/26418441en_US
dc.identifier.doi10.1111/imj.12917en_US
dc.type.contentTexten_US
dc.type.austinJournal Articleen_US
local.name.researcherChandran, Sujievvan
item.openairetypeJournal Article-
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.grantfulltextnone-
item.fulltextNo Fulltext-
item.cerifentitytypePublications-
crisitem.author.deptGastroenterology and Hepatology-
crisitem.author.deptGastroenterology and Hepatology-
crisitem.author.deptGastroenterology and Hepatology-
Appears in Collections:Journal articles
Show simple item record

Page view(s)

18
checked on Mar 27, 2024

Google ScholarTM

Check


Items in AHRO are protected by copyright, with all rights reserved, unless otherwise indicated.