Physician assessment and management of complex colon polyps

a multicenter video-based survey study.

A. Aziz Aadam, Sachin Wani, Charles Kahi, Tonya Kaltenbach, Young Oh, Steven Edmundowicz, Jie Peng, Alfred Rademaker, Swati Patel, Vladimir Kushnir, Mukund Venu, Roy Soetikno, Rajesh N. Keswani

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

The management of complex colorectal polyps varies in practice. Accurate descriptions of the endoscopic appearance by using a standardized classification system (Paris classification) and size for complex colon polyps may guide subsequent providers regarding curative endoscopic resection vs. need for surgery. The accuracy of this assessment is not well defined. Furthermore, the factors associated with decisions for endoscopic vs. surgical management are unclear. To characterize the accuracy of physician assessment of polyp morphology, size, and suspicion for malignancy among physician subspecialists performing colonoscopy and colon surgery. In addition, we aimed to assess the influence of these polyp characteristics as well as physician type and patient demographics on recommendations for endoscopic vs. surgical resection of complex colorectal polyps. An online video-based survey was sent to gastroenterologists (GIs) and gastrointestinal surgeons affiliated with six tertiary academic centers. The survey consisted of high-definition video clips (30-60 s) of six complex colorectal polyps (one malignant) and clinical histories. Respondents were blinded to histology. Respondents were queried regarding polyp characteristics, suspicion for malignancy, and recommendations for resection. The survey response rate was 154/317 (49%). Seventy-eight percent of respondents were attending physicians (91 GIs and 29 surgeons) and 22% were GI trainees. Sixteen percent of respondents self-identified as specialists in complex polypectomy. Accurate estimation of polyp size was poor (28.4%) with moderate interobserver agreement (k=0.52). Accuracy for Paris classification was 47.5%, also with moderate interobserver agreement (k=0.48). Specialists in complex polypectomy were most accurate, whereas surgeons were the least accurate in assigning Paris classification (66.0 vs. 28.7%, P

Original languageEnglish (US)
Pages (from-to)1312-1324
Number of pages13
JournalAmerican Journal of Gastroenterology
Volume109
Issue number9
DOIs
StatePublished - 2014

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Polyps
Colon
Physicians
Paris
Surveys and Questionnaires
Colonoscopy
Surgical Instruments
Neoplasms
Histology
Demography
Gastroenterologists
Surgeons

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Physician assessment and management of complex colon polyps : a multicenter video-based survey study. / Aziz Aadam, A.; Wani, Sachin; Kahi, Charles; Kaltenbach, Tonya; Oh, Young; Edmundowicz, Steven; Peng, Jie; Rademaker, Alfred; Patel, Swati; Kushnir, Vladimir; Venu, Mukund; Soetikno, Roy; Keswani, Rajesh N.

In: American Journal of Gastroenterology, Vol. 109, No. 9, 2014, p. 1312-1324.

Research output: Contribution to journalArticle

Aziz Aadam, A, Wani, S, Kahi, C, Kaltenbach, T, Oh, Y, Edmundowicz, S, Peng, J, Rademaker, A, Patel, S, Kushnir, V, Venu, M, Soetikno, R & Keswani, RN 2014, 'Physician assessment and management of complex colon polyps: a multicenter video-based survey study.', American Journal of Gastroenterology, vol. 109, no. 9, pp. 1312-1324. https://doi.org/10.1038/ajg.2014.95
Aziz Aadam, A. ; Wani, Sachin ; Kahi, Charles ; Kaltenbach, Tonya ; Oh, Young ; Edmundowicz, Steven ; Peng, Jie ; Rademaker, Alfred ; Patel, Swati ; Kushnir, Vladimir ; Venu, Mukund ; Soetikno, Roy ; Keswani, Rajesh N. / Physician assessment and management of complex colon polyps : a multicenter video-based survey study. In: American Journal of Gastroenterology. 2014 ; Vol. 109, No. 9. pp. 1312-1324.
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AU - Peng, Jie

AU - Rademaker, Alfred

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