CC BY-NC-ND 4.0 · Endosc Int Open 2022; 10(01): E30-E36
DOI: 10.1055/a-1618-5525
Original article

Expertise in colonoscopy intubation does not predict diagnostic accuracy: a simulation-based study

Andreas S. Vilmann
1   Rigshospitalet – CAMES, Copenhagen, Denmark
Christian Lachenmeier
1   Rigshospitalet – CAMES, Copenhagen, Denmark
Morten Bo S. Svendsen
1   Rigshospitalet – CAMES, Copenhagen, Denmark
Bo Soendergaard
1   Rigshospitalet – CAMES, Copenhagen, Denmark
2   University Hospital Hvidovre, Department of Gastroenterology and Gastrointestinal Surgery, Copenhagen, Denmark
Yoon S. Park
3   Harvard Medical School, Department of Medical Education Massachusetts Hospital, USA
Lars Bo Svendsen
1   Rigshospitalet – CAMES, Copenhagen, Denmark
4   Rigshospitalet – Surgical Gastroenterology, Copenhagen, Denmark
Lars Konge
1   Rigshospitalet – CAMES, Copenhagen, Denmark
5   University of Copenhagen and the Capital Region of Denmark – Centre for Clinical Education, Copenhagen, Denmark
› Author Affiliations


Background and study aims Studies have linked cecal intubation rate with adenoma detection rate; however, the direct association between technical performance during colonoscopy intubation and withdrawal has never been explored. Thus, it remains unclear whether gentle and efficient intubation predicts superior mucosal inspection. The aim of this study was to investigate the correlation between performance during intubation and withdrawal in a simulation-based setup.

Methods Twenty-four physicians with various experience in colonoscopy performed twice on the Endoscopy Training System (ETS). Intubation skills were evaluated by assessing tasks on the ETS related to intubation (scope manipulation and loop management) and use of a computerized assessment tool called the 3D-Colonoscopy Progression Score (3D-CoPS). Diagnostic accuracy was defined by the number of polyps found during the ETS task of mucosal inspection. Pearson’s correlations were calculated to explore associations between intubation skill and diagnostic accuracy.

Results The correlation analysis between 3D-CoPS and number of polyps found during mucosal inspection revealed a weak and insignificant correlation (0.157, P = 0.3). Likewise, an insignificant correlation was seen between ETS intubation and number of polyps found (0.149, P = 0.32).

Conclusions We found no evidence to support that technical performance during intubation is correlated with mucosal inspection performance in a simulation-based setting.

Publication History

Received: 29 November 2020

Accepted: 22 June 2021

Article published online:
14 January 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (

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