{"id":1881,"date":"2010-10-01T01:00:00","date_gmt":"2010-10-01T00:00:00","guid":{"rendered":"https:\/\/angh.net\/abstracts\/comment-evaluer-le-rendement-diagnostique-des-coloscopies-en-routine\/"},"modified":"2018-10-20T18:39:51","modified_gmt":"2018-10-20T16:39:51","slug":"comment-evaluer-le-rendement-diagnostique-des-coloscopies-en-routine","status":"publish","type":"post","link":"https:\/\/angh.net\/abstracts\/comment-evaluer-le-rendement-diagnostique-des-coloscopies-en-routine\/","title":{"rendered":"Comment \u00e9valuer le rendement diagnostique des coloscopies en routine ?"},"content":{"rendered":"

2010<\/strong><\/p>\n

Bernard DENIS, Jacques BOTTLAENDER, Anne Marie WEISS, Andr\u00e9 PETER, Gilles BREYSACHER, Pascale CHIAPPA, Erik Andr\u00e9 SAULEAU, Isabelle GENDRE, Philippe PERRIN
\nM\u00e9decine A, H\u00f4pitaux Civils de Colmar. ADECA Alsace.<\/em><\/p>\n

Endoscopie <\/strong>– \u00a02010-06-02 –\u00a0 –<\/p>\n

________________________________<\/p>\n

Le taux de d\u00e9tection des ad\u00e9nomes (TDA) au sein du programme national de d\u00e9pistage organis\u00e9 (DO) du cancer colorectal (CCR) par Hemoccult a \u00e9t\u00e9 propos\u00e9 pour \u00e9valuer la qualit\u00e9 des coloscopies (1). Le but de ce travail \u00e9tait de d\u00e9finir le(s) indicateur(s) de rendement diagnostique le(s) mieux appropri\u00e9(s) pour une utilisation en routine et d\u2019\u00e9tablir un standard pour le DO du CCR par Hemoccult.
\nM\u00e9thodes : Comparaison de plusieurs indicateurs \u00e9valuant les coloscopies r\u00e9alis\u00e9es pour Hemoccult positif dans le cadre du DO du CCR au sein d\u2019un d\u00e9partement pilote de 2003 \u00e0 2009.
\nR\u00e9sultats : 5852 coloscopies \u00e9taient r\u00e9alis\u00e9es par 37 gastroent\u00e9rologues (GE)(de 7 \u00e0 375). Il n\u2019y avait pas de diff\u00e9rence significative de recrutement entre GE pour ce qui concerne la r\u00e9partition par \u00e2ge des patients, ni pour ce qui concerne leur r\u00e9partition par sexe au-del\u00e0 d\u2019un effectif de 70 coloscopies. Le taux de coloscopies avec ≥ 1 ad\u00e9nome (TDA) standardis\u00e9 pour l\u2019\u00e2ge et le sexe variait selon le GE de 11.1 \u00e0 54.2% (de 11.1 \u00e0 71.7% pour le taux de coloscopies avec ≥ 1 polype (TDP)). La corr\u00e9lation entre TDA et TDP \u00e9tait bonne (coeff. de corr\u00e9lation de Pearson r = 0.88, p < 0.001). La corr\u00e9lation entre TDA ≥10 mm et TDP ≥10 mm \u00e9tait excellente (coeff. de corr\u00e9lation de Pearson r = 0.98, p < 0.001). Les nombres moyens standardis\u00e9s d\u2019ad\u00e9nomes (NMA) et de polypes (NMP) par coloscopie variaient selon le GE de 0.6 \u00e0 2.5 et de 0.9 \u00e0 2.8. La corr\u00e9lation entre NMA et NMP \u00e9tait bonne (r = 0.89, p < 0.001). Les GE \u00e9taient class\u00e9s en 2 groupes de faible et fort rendement par rapport \u00e0 la m\u00e9diane pour chaque indicateur et sexe. Le NMP offrait une meilleure discrimination entre les 2 groupes que le TDP : pente sup\u00e9rieure, meilleure variance intergroupe et plus grande distance euclidienne intergroupe. Que l\u2019on adopte le NMA ou le NMP, la concordance des classements des GE au sein des 2 groupes \u00e9tait excellente (Kappa = 0.87).
\nConclusions : Le recrutement des coloscopies pour Hemoccult positif dans le DO CCR est homog\u00e8ne de sorte qu\u2019il peut servir de population de r\u00e9f\u00e9rence pour l\u2019\u00e9valuation du rendement des endoscopistes. Le NMA est aussi simple \u00e0 calculer mais plus discriminant que le TDA. Le NMA est bien corr\u00e9l\u00e9 au NMP, de sorte que le NMP, plus simple \u00e0 calculer car imm\u00e9diat et ind\u00e9pendant de l\u2019examen anatomo-pathologique, peut \u00eatre utilis\u00e9 en routine par tout GE pour son \u00e9valuation des pratiques professionnelles. Dans une d\u00e9marche d\u2019am\u00e9lioration de la qualit\u00e9, les seuils de NMP \u00e0 d\u00e9passer sont de 1.1 chez l\u2019homme, 0.5 chez la femme et 0.8 pour les 2 sexes confondus.
\n1 \u2013 Bretagne JF, Ponchon T. Endoscopy 2008 ;40 :523-8.<\/p>\n","protected":false},"excerpt":{"rendered":"

2010 Bernard DENIS, Jacques BOTTLAENDER, Anne Marie WEISS, Andr\u00e9 PETER, Gilles BREYSACHER, Pascale CHIAPPA, Erik Andr\u00e9 SAULEAU, Isabelle GENDRE, Philippe PERRIN M\u00e9decine A, H\u00f4pitaux Civils de Colmar. ADECA Alsace. Endoscopie – \u00a02010-06-02 –\u00a0 – ________________________________ Le taux de d\u00e9tection des ad\u00e9nomes (TDA) au sein du programme national de d\u00e9pistage organis\u00e9 (DO) du cancer colorectal (CCR) […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[6],"tags":[21],"class_list":["post-1881","post","type-post","status-publish","format-standard","hentry","category-endoscopie","tag-21"],"yoast_head":"\nComment \u00e9valuer le rendement diagnostique des coloscopies en routine ? - Abstracts des congr\u00e8s de l'ANGH<\/title>\n<meta name=\"description\" content=\"ANGH R\u00e9sum\u00e9s congr\u00e8s H\u00e9patologie Gastroent\u00e9romogie Hepatology Gastroenterology Etudes cliniques Clinical study\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/angh.net\/abstracts\/comment-evaluer-le-rendement-diagnostique-des-coloscopies-en-routine\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Comment \u00e9valuer le rendement diagnostique des coloscopies en routine ? 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