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Study Title and Description

Routine Colonoscopy after Acute Uncomplicated Diverticulitis - Challenging a Putative Indication.



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 Routine Colonoscopy after Acute Uncomplicated Diverticulitis - Challenging a Putative Indication.
Author Andrade P., Ribeiro A., Ramalho R., Lopes S., Macedo G.
Country Department of Gastroenterology, Faculty of Medicine, Centro Hospitalar de São João, Porto, Portugal.
Year 2017
Numbers Pubmed ID: 27941344

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
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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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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 2008
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2013
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Inclusion criteria patients who underwent a colonoscopy within 1 year after the conservative management of CT-proven acute diverticulitis
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Exclusion criteria emergency surgery, incomplete colonoscopy
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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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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)
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Country Portugal
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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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Other 1 ... Hinchey Ia vs. Hinchey ≥Ib
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Other 2 ... Abscess on CT vs. No abscess on CT
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Baseline Characteristics
Question Colonoscopy Total Comments
AnswerFollow-up AnswerFollow-up
Participant race/ethnicity characteristics Male 49.2 Male 49.2
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Participant age, continuous 55 55
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11.1 11.1
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Age >=50, % NR NR
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Participants with Un/Complicated Diverticulitis Not reported Not reported
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Note/Comment about baseline characteristics No data entered.
Alarm symptoms No data entered.



Results & Comparisons


Results Data
Outcome: Colorectal cancer      Population: All Participants
Time Point Measure Colonoscopy


Enter a numeric value or title (required) years

 N Analyzed 252
Counts 8
Percentage 3.2
note For the variable of "abscess on CT", OR (95% CI): 3.15 (1.586-11.586), p=0.036 in multivariate logistic regression (advanced colonic neoplasia as the outcome)
Outcome: Colorectal cancer      Population: Hinchey Ia
Time Point Measure Colonoscopy


Enter a numeric value or title (required) years

 N Analyzed 209
Counts 1
Percentage 0.5
note For the variable of Hinchey classification, OR (95% CI): 3.37 (1.547-13.547), p=0.035 in multivariate logistic regression
Outcome: Colorectal cancer      Population: Hinchey ≥Ib
Time Point Measure Colonoscopy


Enter a numeric value or title (required) years

 N Analyzed 43
Counts 7
Percentage 16.3
Outcome: Adenomas, multiple      Population: All Participants
Time Point Measure Colonoscopy


Enter a numeric value or title (required) years

 N Analyzed 252
Counts 13
Percentage 5.1
Outcome: Adenomas, multiple      Population: Hinchey Ia
Time Point Measure Colonoscopy


Enter a numeric value or title (required) years

 N Analyzed 209
Counts 11
Percentage 5.3
Outcome: Adenomas, multiple      Population: Hinchey ≥Ib
Time Point Measure Colonoscopy


Enter a numeric value or title (required) years

 N Analyzed 43
Counts 2
Percentage 4.7
Outcome: Failed/incomplete procedure      Population: All Participants
Time Point Measure Colonoscopy


Enter a numeric value or title (required) years

 N Analyzed 261
Counts 9
Percentage 3.4
Outcome: Advance Adenoma      Population: All Participants
Time Point Measure Colonoscopy


Enter a numeric value or title (required) years

 N Analyzed 252
Counts 13
Percentage 5.1
note


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.