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July 28, 2004

Virtual Colonoscopy

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2004;292(4):431-433. doi:10.1001/jama.292.4.432-a

To the Editor: The results of studies by Dr Cotton and colleagues1 may reflect the fact that a proportion of radiologists were not qualified to interpret CTC.2 The authors state that participating radiologists merely had to have performed 10 procedures and that some centers recruited as few as 10 patients. Furthermore, there was no formal feedback to the participating radiologists, inferring that the analysis of sequential accrual blocks was meaningless. The opportunity to determine any learning curve was lost.1 Unfortunately, the proportion of relatively inexperienced radiologists cannot be determined from the article. In contrast, while the experience of the colonoscopists is also undefined, the fact that their completion rate was 98.5% indicates that they were very capable indeed. In comparison, a recent UK audit of 9223 procedures found an adjusted cecal intubation rate of only 56.9%.3

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