Videorecording may improve colonoscopy performance

NEW YORK (Reuters Health) - New research suggests that videorecording of colonoscopies may enhance operator technique and result in more thorough examinations.

"We found that videotaping resulted in a change in physician behavior," lead researcher Dr. Douglas Rex, from Indiana University Medical Center in Indianapolis, told Reuters Health. "Basically the doctors went slower and looked more carefully."

Dr. Rex presented the study findings this week at the American College of Gastroenterology annual meeting in San Diego, California.

The study featured seven experienced endoscopists who first performed 8 to 10 colonoscopies that were digitally recorded without their knowledge. The physicians then performed 8 to 10 more colonoscopies that were recorded with their awareness.

A reviewer blinded to the endoscopist and to the awareness status graded the quality of the exams on various parameters, such as quality of examination of the proximal surface of folds and quality of distention. The inspection time for each exam was also documented.

The average inspection time for videotaped-aware exams was longer than that for videotaped-unaware exams: 7.3 vs. 4.9 minutes (p < 0.0001).

The overall quality score (on a 5-point scale) was also better for videotaped-aware exams: 3.8 vs. 2.9 for unaware exams (p < 0.0001). Significant improvements were also noted in subscales for fold examination, distension, clean up, and subjective time for examination.

"At this point, patients should seek out doctors with proven high adenoma detection rates," Dr. Rex said.

"In the future, perhaps systematic videorecording of colonoscopies will be considered," he said. Still, "it remains to be seen if these improvements in (endoscopist) behavior would be sustained over time with continued videorecording."

Copyright © 2009 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.