Reply to Saritas et al.

I appreciate the constructive comment from Saritas and Ustundag on our article exploring the role of withdrawal time as a quality indicator in colonoscopy. We chose to adhere to the generally accepted definition of polyp detection rate (PDR) as the percentage of colonoscopies with findings of one or more polyps performed by an individual endoscopist. This enabled us to compare our results with other studies based on the same PDR definition. Counting numbers of polyps would make the analysis vulnerable to outliers due to patients with polyposis syndromes and extremely high polyp numbers.

Counting polyps regardless of size would give small hyperplastic polyps a disproportionately heavy impact on the results without being clinically relevant. This would make it necessary to implement the analysis of adenoma detection rate and would require matching polyp findings with histological results. We regard this as hardly feasible in the context of a quality assurance project involving a great number of centers and endoscopists. Therefore, we decided to focus on the number of colonoscopies with polyp findings rather than the number of polyps found per colonoscopy.

We regard the results of our analysis, based on polyp detection rate according to the generally accepted definition, as more robust.