Ann Surg Treat Res.  2019 Dec;97(6):319-325. 10.4174/astr.2019.97.6.319.

Validation of an automated adenoma detection rate calculating system for quality improvement of colonoscopy

  • 1Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
  • 2Information Technology Team, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
  • 3Endoscopy Room, Research Institute and Hospital, National Cancer Center, Goyang, Korea.


This study aimed to validate an automated calculating system developed for determining the adenoma detection rate (ADR).
To calculate the automated ADR, the data linking processes were as follows: (1) matching the selected colonoscopy results with the pathological results, (2) matching the polyp number from colonoscopy with that from pathology and confirming the histopathological results of each colonic polyp, and (3) confirming the histopathological results, especially the adenoma status of each colonic polyp. To verify the accuracy of the automated ADR calculating system, we manually calculated the ADR for 3 months through medical record review. Accuracy was calculated by measuring the error rate for each value. The cause of error was analyzed by additional order and chart review.
After excluding 318 cases, 2,543 patients (1,351 men and 1,192 women; median age, 57.9 years) who underwent colonoscopy were included in this study. When the automated calculating system was used, polyps were found in 1,336 cases (52.6%) and adenomas were found in 1,003 cases (39.4%). When the manual calculating system was used, polyps were found in 1,327 cases (52.2%) and adenomas were found in 1,003 cases (39.4%). The accuracies of the polyp detection rate and ADR according to the automated calculating system were 99.3% and 100%, respectively.
We developed a system to automatically calculate the ADR by extracting hospital electronic medical record results and verified that it provided satisfactory results. It may help to improve colonoscopy quality.


Colon; Colonoscopy; Colorectal neoplasms; Electronic health records; Quality improvement

MeSH Terms

Colonic Polyps
Colorectal Neoplasms
Electronic Health Records
Medical Records
Quality Improvement*


  • Fig. 1 Colonoscopy report form.

  • Fig. 2 Pathology report form.


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