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Study Title and Description

Colonoscopy following nonoperative management of uncomplicated diverticulitis may not be warranted.



Key Questions Addressed
3 KQ 3: What are the benefits and harms of colonoscopy (or other colon imaging test) following an episode of acute diverticulitis? KQ 3a. What is the incidence of malignant and premalignant colon tumors found by colonoscopy, and what is the incidence of colon cancer mortality among patients undergoing screening? KQ 3b. What are the procedure-related and other harms of colonoscopy or CT colonography? KQ 3c. What is the frequency of inadequate imaging due to intolerance or technical feasibility? • Do the benefits and harms vary by patient characteristics, course of illness, or other factors?
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Primary Publication Information
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TitleData
Title Colonoscopy following nonoperative management of uncomplicated diverticulitis may not be warranted.
Author Brar MS., Roxin G., Yaffe PB., Stanger J., MacLean AR., Buie WD.
Country 1 Department of Surgery, University of Calgary, Calgary, Alberta, Canada 2 Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.
Year 2013
Numbers Pubmed ID: 24105001

Secondary Publication Information
There are currently no secondary publications defined for this study.


Extraction Form: KQ 3: Colonoscopy
Arms
Number Title Description Comments
1 Colonoscopy endoscopy within a year of admission
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Design Details
Question... Follow Up Answer Follow-up Answer
Study design Single group, with subgroup analyses
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Single group, with subgroup analyses
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Single group, with subgroup analyses
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Single group, with subgroup analyses
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Single group, with subgroup analyses
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Single group, with subgroup analyses
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if not an RCT, what was the directionality? Retrospective
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Funder Not reported (or unclear)
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Start and end years of the study 2007
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2010
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Inclusion criteria patients successfully treated nonoperatively for acute left-sided diverticulitis, and all endoscopy reports before index admission and within 1 year after admission
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Exclusion criteria patients underwent endoscopies more than 1 year after admission, patients underwent complete colonoscopy within the 2 years before admission
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Specific population? No (anyone with Hx diverticulitis)
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No (anyone with Hx diverticulitis)
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No (anyone with Hx diverticulitis)
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No (anyone with Hx diverticulitis)
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No (anyone with Hx diverticulitis)
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No (anyone with Hx diverticulitis)
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Note/Comment about Design (or overall study) There were comparison of colonoscopy vs. no colonoscopy groups on background characteristics, but no information on the outcome of colorectal cancer
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Country Canada
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Comparison of colonoscopy vs. no colonoscopy? No
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Comparison of diverticulitis vs health control? No
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Subgroup analyses? Age <> 50
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Complicated vs uncomplicated D
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Other 1 ... anemia vs. no anemia
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Other 2 ... previous attack vs. no previous attack
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Baseline Characteristics
Question Colonoscopy Total Comments
AnswerFollow-up AnswerFollow-up
Participant race/ethnicity characteristics Male 49
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Participant age, continuous 55
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27
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90
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Age >=50, % 63.5
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Participants with Un/Complicated Diverticulitis Complicated diverticulitis 29.7
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Uncomplicated diverticulitis 70.3
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Note/Comment about baseline characteristics No data entered.
Alarm symptoms No data entered.



Results & Comparisons


Results Data
Outcome: Adenomas, multiple      Population: All Participants
Time Point Measure Colonoscopy


Enter a numeric value or title (required) years

 N Analyzed 249
Counts 19
Percentage 7.6
Outcome: Adenomas, multiple      Population: <50 years old
Time Point Measure Colonoscopy


Enter a numeric value or title (required) years

 N Analyzed 91
Counts 3
Percentage 3.3
Outcome: Adenomas, multiple      Population: >50 years old
Time Point Measure Colonoscopy


Enter a numeric value or title (required) years

 N Analyzed 158
Counts 16
Percentage 10.1
Outcome: Adenomas, multiple      Population: uncomplicated diverticulitis
Time Point Measure Colonoscopy


Enter a numeric value or title (required) years

 N Analyzed 175
Counts 9
Percentage 5.1
Outcome: Adenomas, multiple      Population: complicated diverticulitis (abscess)
Time Point Measure Colonoscopy


Enter a numeric value or title (required) years

 N Analyzed 74
Counts 14
Percentage 18.9
Outcome: Colorectal cancer      Population: All Participants
Time Point Measure Colonoscopy


Enter a numeric value or title (required) years

 N Analyzed 249
Counts 4
Percentage 1.6
Outcome: Colorectal cancer      Population: <50 years old
Time Point Measure Colonoscopy


Enter a numeric value or title (required) years

 N Analyzed 91
Counts 0
Percentage 0
Outcome: Colorectal cancer      Population: >50 years old
Time Point Measure Colonoscopy


Enter a numeric value or title (required) years

 N Analyzed 158
Counts 4
Percentage 2.5
Outcome: Colorectal cancer      Population: uncomplicated diverticulitis
Time Point Measure Colonoscopy


Enter a numeric value or title (required) years

 N Analyzed 175
Counts 0
Percentage 0
Outcome: Colorectal cancer      Population: complicated diverticulitis (abscess)
Time Point Measure Colonoscopy


Enter a numeric value or title (required) years

 N Analyzed 74
Counts 4
Percentage 5.4
Outcome: Advance Adenoma      Population: All Participants
Time Point Measure Colonoscopy


Enter a numeric value or title (required) years

 N Analyzed 249
Counts 19
Percentage 7.6


Quality Dimensions
Dimension Value Notes Comments
Q23: NHLBI - Were eligibility/selection criteria for the study population prespecified and clearly described? Yes
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Q25: NHLBI - Were the outcome measures prespecified, clearly defined, valid, reliable, and assessed consistently across all study participants? Yes
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If this study was an NRCS or a single-group study, did the study report adjusted results that were for differences between groups (in the case of NRCSs) or differences between subgroups (in the case of single group studies)? Yes
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Quality Rating
No quality rating data was found.