{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T22:28:08Z","timestamp":1773527288007,"version":"3.50.1"},"reference-count":42,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n            <jats:title>Goals:<\/jats:title>\n            <jats:p>We aimed to evaluate whether direct access colonoscopy (DAC) is noninferior to office-scheduled colonoscopy (OSC) for achieving successful colonoscopy.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>DAC may improve access to colonoscopy. We developed an algorithm assessing eligibility, risk for inadequate preparation, and need for nursing\/navigator assistance.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Study:<\/jats:title>\n            <jats:p>This was a retrospective, single-center study of DAC and OSC patients from June 5, 2018, to July 31, 2019. Patients were 45 to 75 years old with an indication of screening or surveillance. A successful colonoscopy met 3 criteria: complete colonoscopy (cecum, anastomosis, or ileum), adequate preparation (Boston Score \u22652\/segment), and performed &lt;90 days from initial patient contact. Unsuccessful colonoscopy did not meet \u22651 criteria. Secondary end points included days to successful colonoscopy, preparation quality, polyp detection, and 10-year recall rate. Noninferiority against risk ratio value of 0.85 was tested using 1-sided alpha of 0.05.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>A total of 1823 DAC and 828 OSC patients were eligible. DAC patients were younger, with a greater proportion of black patients and screening indications. For the outcome of successful colonoscopy, DAC was noninferior to OSC (DAC vs. OSC: 62.7% vs. 57.1%, RR 1.16, 95% LCL 1.09, <jats:italic toggle=\"yes\">P<\/jats:italic>=0.001). For DAC, days to colonoscopy were fewer, and likelihood of 10-year recall after negative screening greater. Boston Score and polyp detection were similar for groups. Black patients were less likely to achieve successful colonoscopy; otherwise, groups were similar. For unsuccessful colonoscopies, proportionally more DAC patients canceled or no-showed while more OSC patients scheduled &gt;90 days. DAC remained noninferior to OSC at 180 days.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>DAC was noninferior to OSC for achieving successful colonoscopy, comparing similarly in quality and efficiency outcomes.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/mcg.0000000000002000","type":"journal-article","created":{"date-parts":[[2024,4,17]],"date-time":"2024-04-17T18:03:29Z","timestamp":1713377009000},"page":"219-226","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Timely Completion of Direct Access Colonoscopy Is Noninferior to Office Scheduled for Screening and Surveillance"],"prefix":"10.1097","volume":"59","author":[{"given":"Mary","family":"White","sequence":"first","affiliation":[{"name":"Sidney Kimmel Medical College"},{"name":"Department of Internal Medicine, Yale New Haven Hospital, New Haven, CT"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel","family":"Israilevich","sequence":"additional","affiliation":[{"name":"Sidney Kimmel Medical College"},{"name":"Department of Ophthalmology, Mayo Clinic, Rochester, MN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sophia","family":"Lam","sequence":"additional","affiliation":[{"name":"Sidney Kimmel Medical College"},{"name":"Department of Ophthalmology, New York Eye and Ear Infirmary, New York City, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"McCarthy","sequence":"additional","affiliation":[{"name":"Sidney Kimmel Medical College"},{"name":"Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vasil","family":"Mico","sequence":"additional","affiliation":[{"name":"Sidney Kimmel Medical College"},{"name":"Department of Medicine, Tufts Medical Center, Boston"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Chipkin","sequence":"additional","affiliation":[{"name":"Sidney Kimmel Medical College"},{"name":"Department of Internal Medicine, Yale New Haven Hospital, New Haven, CT"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Abrams","sequence":"additional","affiliation":[{"name":"Department of Biology, University of Massachusetts-Amherst, Amherst, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelly","family":"Moore","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Thomas Jefferson University, Philadelphia, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Kastenberg","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Thomas Jefferson University, Philadelphia, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2025,3]]},"reference":[{"key":"R1-20250310","doi-asserted-by":"crossref","first-page":"7","DOI":"10.3322\/caac.21708","article-title":"Cancer statistics, 2022","volume":"72","author":"Siegel","year":"2022","journal-title":"CA Cancer J Clin"},{"key":"R2-20250310","article-title":"American Cancer Society. 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