The impact of video recording colonoscopy on adenoma detection rates

BackgroundThe adenoma detection rate (ADR) is a quality benchmark for colonoscopy, influenced by several factors including bowel preparation, withdrawal time, and withdrawal technique.ObjectiveTo assess the impact of video recording of all colonoscopies on the ADR.DesignComparison of two cohorts of patients undergoing colonoscopy before and after implementation of video recording.SettingAcademic outpatient endoscopy facility.PatientsThis study involved asymptomatic, average-risk adults undergoing screening colonoscopy.InterventionVideo recording of all colonoscopy procedures. Polyp findings and withdrawal times were recorded for 208 consecutive screening colonoscopies. A policy of video recording all colonoscopies was implemented and announced to the staff. Data on another 213 screening colonoscopies were subsequently collected.Main Outcome MeasurementsAdenoma detection rate, withdrawal time, advanced polyp detection rate, hyperplastic polyp detection rate.ResultsAt least one adenoma was found in 38.5% of patients after video recording versus 33.7% before video recording (P = .31). There was a significant increase in the hyperplastic polyp detection rate (44.1% vs 34.6%; P = .046). Most endoscopists had a numerical increase in their ADRs, but only one was significant (57.7% vs 22.6%; P < .01). There were trends toward higher detection of adenomas of <5 mm (59.1% vs 52%; P = .23) and right-sided adenomas (40.2% vs 30.4%; P = .11) in the video recorded group.LimitationsNo randomization, confounding of intervention effects, and sample size limitations.ConclusionVideo recording of colonoscopies is associated with a nonsignificant increase in the ADR and a significant increase in the hyperplastic polyp detection rate. There may be a benefit of video recording for endoscopists with low ADRs.