Theodore R. Levin, MD
Potential Financial Conflicts of Interest: None disclosed.
Levin T.; Complications of Colonoscopy. Ann Intern Med. 2007;147:213-214. doi: 10.7326/0003-4819-147-3-200708070-00017
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Published: Ann Intern Med. 2007;147(3):213-214.
I thank Drs. McDonnell and Loura for their interest in our paper. Their comments reflect what may be a misunderstanding about how our study was conducted, which procedures and patients were included, and the status and training of the endoscopists in our study.
First, all the endoscopists included in our study were staff physicians, and no trainees were involved. Second, more than half of the identified colonoscopies in the various databases used to build the study data set were not included in the analysis. Of the 35 945 colonoscopies identified, only 16 318 were eventually included in the study data set. For 1994 to 1996, the Colon Cancer Prevention Program database included only colonoscopies done within 6 months of a flexible sigmoidoscopy. Therefore, the numbers of colonoscopies per endoscopist described in our paper represent only a fraction of the endoscopic activity of these endoscopists. Each endoscopist performed more procedures than were included in the final study data set.
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