Gastrointestinal endoscopy
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Gastrointest. Endosc. · Mar 2018
Multicenter Study Comparative Study Observational StudyA prospective comparison of live and video-based assessments of colonoscopy performance.
Colonoscopy performance is typically assessed by a supervisor in the clinical setting. There are limitations of this approach, however, because it allows for rater bias and increases supervisor workload demand during the procedure. Video-based assessment of recorded procedures has been proposed as a complementary means by which to assess colonoscopy performance. This study sought to investigate the reliability, validity, and feasibility of video-based assessments of competence in performing colonoscopy compared with live assessment. ⋯ Video-based assessments of colonoscopy procedures using the GiECAT have strong evidence of reliability and validity. In addition, assessments using videos were feasible, although live assessments were easier.
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Gastrointest. Endosc. · Mar 2018
Randomized Controlled Trial Multicenter Study Pragmatic Clinical TrialEffect of left lateral tilt-down position on cecal intubation time: a 2-center, pragmatic, randomized controlled trial.
Colonoscopy insertion is technically challenging, time-consuming, and painful, especially for the sigmoid. Several pilot studies indicated that the (left) tilt-down position could facilitate the insertion procedure, but no formal trials have been published to demonstrate its efficacy. We performed this study to verify the benefits of the left lateral tilt-down position (LTDP) on the insertion process. ⋯ LTDP for colonoscopy insertion can reduce insertion time and pain, and potentially improves patients' acceptance of unsedated colonoscopy. (Clinical trial registration number: NCT02842489.).
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Gastrointest. Endosc. · Mar 2018
Multicenter StudyImpact of experience on self-assessment accuracy of clinical colonoscopy competence.
Self-assessment is important for life-long learning and a recommended assessment method for endoscopy skills. Prior literature has not investigated self-assessment accuracy of colonoscopic competence in the clinical setting. This study aimed to determine the self-assessment accuracy of novice, intermediate, and experienced endoscopists. ⋯ Participants demonstrated moderate self-assessment accuracy of clinical competence. Endoscopist experience was positively associated with self-assessment accuracy; novices demonstrated lower self-assessment accuracy compared with experienced endoscopists. Moreover, novices tended to overestimate their performances. Novice endoscopists may benefit from targeted interventions to improve self-assessment accuracy.
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Gastrointest. Endosc. · Feb 2018
Practice GuidelineGuidelines for sedation and anesthesia in GI endoscopy.
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Gastrointest. Endosc. · Feb 2018
Randomized Controlled Trial Multicenter StudyEffect of scheduled second-look endoscopy on peptic ulcer bleeding: a prospective randomized multicenter trial.
This study aimed to investigate the effectiveness of scheduled second-look endoscopy (EGD) with endoscopic hemostasis on peptic ulcer rebleeding and to identify the risk factors related to the need for second-look EGD. ⋯ A single EGD with endoscopic hemostasis is not inferior to scheduled second-look endoscopy in terms of reduction in rebleeding rate of peptic ulcer bleeding. Repeat endoscopy would be helpful in the patients with unsatisfactory initial endoscopic hemostasis, use of NSAIDs, and larger amounts of transfused blood. (Clinical trial registration number: KCT0000565; 4-2010-0348.).