Correlation between biopsy rate and positive rate of biopsy in assessment of diagnostic competence in endoscopists

‍Objective‍ ‍To explore whether the biopsy rate and the positive rate of biopsy during colonoscopy can serve as effective indicators for evaluating the diagnostic proficiency of endoscopists. Methods‍ ‍Total fifteen endoscopists from the First Affiliated Hospital of Army Military Medical University, Guiqian International General Hospital and No. 958 Hospital of PLA Army were enrolled and served as the study subjects. According to their years of experience, gender and working hours, they were divided into a senior group (n=8) and a junior group (n=7), a male group (n=9) and a female group (n=6), and a morning period (08:00-12:00) and an afternoon period (13:00-18:00). The data of all patients examined by the aforementioned endoscopists between January 2023 and December 2023 were collected, including the basic demographics, colonoscopic results, biopsy outcomes and pathological diagnoses of the patients. ANOVA was used to analyze the differences in the biopsy rate and positive rate of biopsy existed among the endoscopists of different years of experience, gender and working at different periods (morning and afternoon). Additionally, multivariate logistic regression analysis was employed to identify the independent risk factors associated with positive rates of biopsy. Results‍ ‍The senior group had significantly lower biopsy rate [(5.73±0.81)% vs (6.89±0.97)%], but obviously higher positive rate of biopsy [(53.52±3.87)% vs (33.70±7.85)%] than the junior group (both P<0.01). The biopsy rate was notably higher during the morning working time period than the afternoon working time period in all the endoscopits [(6.76±1.11)% vs (5.53±1.57)%, P<0.05]. Logistic regression analysis showed that the years of experience [(53.52±3.87)% vs (33.70±7.85)%, OR=92.187, 95%CI: 3.118~2 725.366, P<0.01) and working time [(48.35±10.50)% vs (37.80±10.65)%, OR=20.885, 95%CI: 1.266~344.602, P<0.05) were influencing factors for positive rate of biopsy. Conclusion‍ ‍The biopsy rate is low and positive rate of biopsy is high among the senior experienced endoscopists, while, opposite results are seen in the junior experienced clinicians, indicating correlation of biopsy rate and positive rate of biopsy with diagnostic proficiency of endoscopists.