The aim of this study is to evaluate FUSE-colonoscopy in terms of feasibility and its possible additive contribution in the detection of important lesions, namely polyps and cancers, compared to the standard "forward-viewing" approach, with and without the addition of the right-colon retroflexion technique, in a series of patients undergoing back-to-back screening or surveillance colonoscopies in a randomized fashion.
We changed the anticipated number of subjects enrollment for study: NCT02117674 from 120 to 200 based on the following sample size estimation: Tandem colonoscopies studies results, show that novel endoscopic technologies detect about 20% more adenomas than those conventional colonoscopy does (missed adenomas). Since FUSE colonoscopy cannot be considered as a perfect examination, we hypothesize that conventional colonoscopy will detect one third of the missed adenomas that FUSE detects in a similar setting. Therefore a sample size of 120 adenomas achieves 80% power to detect an odds ratio of 3.0 using a two-sided McNemar test with a significance level of 0.05. The odds ratio is equivalent to a difference between two paired proportions of 14% which occurs when the proportion of detected missed adenomas during FUSE is 21% and the proportion of missed adenomas during conventional colonoscopy is 7%. During one year period before the study initiation, our colonoscopy performance quality data show that we detect a mean number of adenomas per patient equal of 0.7 in a population similar to the one recruited in our study. Therefore, 172 patients overall will be required to detect 120 adenomas. Given the uncertainty of our estimation and in order to cope with patients exclusions, withdrawals and unexpected incomplete colonoscopies, we decided to recruit 200 patients. A more extensive description regarding the investigators study is provided in the following fields.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
246
examination of the colon with a conventional colonoscope
examination of the colon with full-spectrum colonoscope
examination of the right colon with scope retroflexion (both with conventional and fuse scope)
417 Nimts Veterans Hopsital
Athens, Greece
Hepatogastroenterology Unit, 2nd Department of Internal Medicine and Research Unit, Attikon University General Hospital
Athens, Greece
polyp detection rate
per colon segment and for the entire colon
Time frame: one week
colonoscopy completion
colonoscopy completion rate
Time frame: one week
procedure time
intubation and withdrawal time
Time frame: one week
adverse events
adverse events rate
Time frame: one week
endoscopist's satisfaction
endoscopist's satisfaction quantified using a scale from 0 (not satisfied) to 10 (completely satisfied)
Time frame: one week
feasibility of the retroflexion in the right colon by trainee
feasibility of retroflexion in the right colon by trainee, meaning if the trainee managed to perform the right colon retroflexion or not
Time frame: one week
feasibility of retroflexion in the right colon by the consultant
feasibility of retroflexion in the right colon by the consultant, meaning if the consultant managed to perform the right colon retroflexion or not
Time frame: one week
patients' satisfaction
patients' satisfaction, quantified using a scale from 0 (not satisfied at all) to 10 (completely satisfied)
Time frame: one week
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