Zero-inflated models for the evaluation of colorectal polyps in colon cancer screening studies—a value-based biostatistics practice

We suggest colonoscopy studies should jointly use the polyp detection rate and polyp counts as the quality measure. Based on theoretical, empirical, and simulation considerations, we encourage analysts to utilize zero-inflated models for evaluating colorectal polyps in colonoscopy screening studies for proper clinical interpretation of data and accurate reporting of findings. A similar approach can also be used for analyzing other types of polyp counts in colonoscopy studies.