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Canadian Journal of Gastroenterology and Hepatology
Volume 2016 (2016), Article ID 4712192, 8 pages
http://dx.doi.org/10.1155/2016/4712192
Research Article

Assessment of a Colonoscopy Triage Sheet for Use in a Province-Wide Population-Based Colorectal Screening Program

1Division of Gastroenterology, McGill University Health Centre, McGill University, 1650 Cedar Avenue, Room D7-346, Montreal, QC, Canada H3G 1A4
2Division of Clinical Epidemiology, Research Institute, McGill University Health Centre, McGill University, 1650 Cedar Avenue, Room D7-346, Montreal, QC, Canada H3G 1A4
3Department of Nursing, McGill University Health Centre, McGill University, 1650 Cedar Avenue, Room D7-346, Montreal, QC, Canada H3G 1A4

Received 9 February 2016; Accepted 31 May 2016

Academic Editor: Mark Borgaonkar

Copyright © 2016 Nour Sharara et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background and Aims. A colonoscopy triage sheet (CTS) integrating 6 hierarchical scheduling priorities based on indications for screening, surveillance, or symptoms was designed for colonoscopy referral. We compared CTS priority ratings by referring physicians and endoscopists, assessing yields. Methods. Retrospective study of consecutive patients. Data were collected on demographics, CTS and endoscopist priority ratings, and endoscopic findings. Weighted kappa values measured interrater agreement on priority assignment. Predictors of agreement and lesions were identified using multivariable analysis. Results. Among 1230 patients (60.3 years, 52.5% female), clinically significant lesions included tumors (1.1%), polyps per patient ≥ 10 mm (7.6%), and ileocolitis (4.6%). Moderate agreement was found between referring physician and endoscopist on all 6 priorities (weighted kappa 0.55 (0.51; 0.59)). P4 and P5 ratings predicted increased agreement (range of OR for P4: 2.47–4.57; P5: 1.58–2.93). Predictors of clinically significant findings were male gender (OR 1.44, 1.03–2.03) and P1/P2 priorities that were significantly superior to P3 (OR = 2.14; 1.04–4.43), P4 (OR = 2.90; 1.35–6.23), and P5 (OR = 4.30; 2.08–8.88). Conclusion. Priority-assignment agreement is moderate and highest for less urgent ratings. Predictors of clinically significant findings validate the hierarchal priority scheme. Broader validation and physician education are needed.