In Reply We thank you all for taking the time to critically evaluate our work.1 With regards to Kawada’s statement, we agree that generally speaking, one would expect that the odds ratio (OR) of the number of annual colonoscopies for proximal sessile serrated polyp detection rate (pSSPDR) to be statistically significant and decreasing with increasing volume. This seems discordant with our study’s findings and may be driven by the fact that pSSPDR was only recently accorded importance as a quality indicator. Therefore, those who have trained more recently have been trained more rigorously to identify pSSPDR. However, this does not take away from the realization that with increased procedure volume, one becomes better at identifying them. Thank you for the clarification regarding the Crockett et al study2 evaluating sessile serrated polyp detection not being derived solely from proximal sessile serrated polyps. While most sessile serrated polyps are proximal, we do agree that further studies are needed with focus on pSSPDR to be an adequate comparator with our study.
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Sarvepalli S, Rizk MK. Patient Characteristics and Adenoma Detection Rates—Reply. JAMA Surg. Published online September 04, 2019. doi:10.1001/jamasurg.2019.3378
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