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The following is a summary of “Timely Completion of Direct Access Colonoscopy Is Noninferior to Office Scheduled for Screening and Surveillance,” published in the April 2024 issue of Gastroenterology by White et al.
Researchers conducted a retrospective study to evaluate the better choice between direct access colonoscopy (DAC) and office-scheduled colonoscopy (OSC) for achieving successful colonoscopies.
They studied patients with DAC and OSC from June 5, 2018, to July 31, 2019, including those aged 45 to 75 who needed colonoscopy for screening or surveillance. Successful procedures met three criteria: complete colonoscopy (cecum, anastomosis, or ileum), adequate preparation (Boston Score ≥2/segment), and performed within 90 days of initial contact. Not meeting more than ≥1 criterion meant an unsuccessful colonoscopy. The secondary endpoint included days to reach a successful colonoscopy, and noninferiority was tested with a risk ratio of 0.85 using a 1-sided alpha of 0.05.
The results showed that 1,823 DAC and 828 patients with OSC were eligible. patients with DAC had more younger and black patients with screening needs. Successful colonoscopy rate was higher in DAC (62.7% vs. 57.1%, RR 1,16, 95% LCL 1.09, P=0.001). DAC waited fewer days and had a greater negative screening for the likelihood of a 10-year recall. Both the groups had similar Boston scores and polyp detection. However, Black patients had lower success rates for successful colonoscopy. DAC remained non-inferior to OSC at 180 days.
Investigators concluded that DAC was non-inferior to OSC in achieving successful colonoscopy compared to quality and efficiency outcomes.
Source: journals.lww.com/jcge/abstract/9900/timely_completion_of_direct_access_colonoscopy_is.287.aspx