P4121 - Does Taking More Endoscopic Images Impact Adenoma Detection? A Quality Improvement Initiative at Our Tertiary Hospital

Shazia Rashid, MD¹, Karan Sachdeva, MD², Daniyal Raza, MD², Lena Kawji, MD², David Okuampa, MD³, Ross Dies, MD², Khadija Khan, MD², Rohit Goyal, MD³, Farhan Mohiuddin, MD⁴, Ahmad Alkurd, MS³, Rawia Aburumman, MD³, Hassaan Zia, MD^3
1Ochsner LSU Health, Nokesville, VA; ²LSU Health, Shreveport, LA; ³Ochsner LSU Health, Shreveport, LA; ⁴LSU Health, New Orleans, LA

Introduction: Endoscopic photo documentation (EPD) is vital for quality control and communication between providers, patients, and family members. The European Society of Gastrointestinal Endoscopy recommends documentation of nine anatomical landmarks during colonoscopy. American Gastroenterology Association recommends that the cecal landmarks (appendiceal orifice and ileocecal valve) should be photo documented. We aim to study the impact of education about endoscopic photo documentation on adenoma detection amongst trainees.

Methods: We carried out a retrospective study analyzing the data collected over a 4-month period (July to August 2023 noted as PRE-education and September and October 2023 noted as POST-education). We reviewed the data related to screening colonoscopies images including the landmarks and adenoma detection for two months noted as PRE-education data. Subsequently, all the 9 GI fellows at our tertiary hospital were educated on endoscopic photo documentation based on ESGE guidelines. Reference cards with images were distributed and posted on monitor screens in all procedure rooms. A review of colonoscopy data over the next two months noted as POST-education period. The data was analyzed using Chi square and independent t-test for categorical and quantitative data, respectively.

Results: 781 colonoscopy procedures were recorded, with 339 PRE education and 442 POST education. The increase in the mean total number of images obtained was statistically significant (PRE 10.82 + 4.15 vs. POST 12.69 + 4.50, p value 0.0001). As compared between PRE and POST analysis, improvements were statistically significant in all, but two categories (cecum/appendiceal orifice and retroflexed view of rectum). Adenoma detection was analyzed for screening colonoscopies only (n=435, PRE: 208 and POST: 227). Mean age was comparable between the two groups (56.6 ±8.8 vs 56.1 ±9.0 years, p-value 0.81). Colonoscopy adenoma detection data is depicted in Table 1. Adenoma detection rate (31.7% vs 32.5%, p-value 0.85) and adenoma per colonoscopy (0.53 vs 0.54, p-value 0.85) were comparable in the PRE vs. POST education groups.

Discussion: Education on endoscopic photo documentation resulted in significant improvement in the number of landmarks captured but this did not translate into improvement in adenoma detection. In this case, endoscopic photo documentation is important, however cannot be used as a quality metric for colonoscopy. Further studies with greater sample size are required to confirm this conclusion.


Disclosures:


Shazia Rashid, MD¹, Karan Sachdeva, MD², Daniyal Raza, MD², Lena Kawji, MD², David Okuampa, MD³, Ross Dies, MD², Khadija Khan, MD², Rohit Goyal, MD³, Farhan Mohiuddin, MD⁴, Ahmad Alkurd, MS³, Rawia Aburumman, MD³, Hassaan Zia, MD³. P4121 - Does Taking More Endoscopic Images Impact Adenoma Detection? A Quality Improvement Initiative at Our Tertiary Hospital, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.