Researcher of the month: Kristoffer wants to ensure the quality of colonoscopy
Kristoffer Mazanti Cold is not the kind of person who gets a pain in the ass. On the contrary. For it will undoubtedly benefit both colleagues and ultimately patients that he, as part of his PhD fellowship at CAMES-Rigshospitalet, will improve the quality when it comes to surgical examinations of the colon and rectum - also called colonoscopy.
Read also: Colonoscopy as a research area at CAMAS
But how will Kristoffer's research help to boost the hit rate in detecting cancer precursors? And why can his research also reduce the pain associated with colonoscopy?
He answers this himself here in "7 quick questions for Kristoffer".
What is the essence of your PhD project?
To improve the quality of colonoscopy via automated feedback. In concrete terms, this means providing the operator with some measure of how well the examination has been performed following the procedure.
At the moment, the quality measure is just the withdrawal time, but it doesn't say much about how thorough you have been. We would like to provide some better descriptive measures.
For example, how much the tip of the bucket has moved as an indication of how much of the bowel wall has actually been examined. And not just how long you spent doing it.
Which medical field?
Gastro-surgery, Gastro-medicine and colonoscopy.
Why that particular area? Where does the interest come from?
I previously researched objective and automated competency measurement here at CAMES, where I discovered that colonoscopy is an extremely user-dependent procedure.
Studies have shown that operators - also known as scopists - who are less likely to find and remove precancerous lesions are unfortunately more likely to have patients who subsequently die of colon cancer.
This compares to the "more skilled" scopists who more frequently detect and remove colorectal cancer precursors. It is thus a procedure - if not the procedure in surgery - where the greatest need for training, development and skills assessment is found.
And here, automated data feedback can help each medical operator get a more accurate picture of whether the quality of each study is good enough.
Can your research also help to reduce pain during the examination?lt ?
As doctors, we're always most interested in the hard facts - like survival. But since colonoscopy is an uncomfortable procedure, we also give patients a questionnaire after the exam.
In fact, we assume that they will also have a more gentle procedure performed and therefore be more willing to receive a second examination if the need arises.
Why are you doing research in the CAMES framework?
I started at CAMES Rigshospitalet 4-5 years ago as a student assistant. This sparked my interest in researching the field - precisely because although the hospital sector has plenty of operators with > 1000 procedures behind them, their approach and quality is very different.
I have therefore been associated as a researcher for the last four years with objectifying and automating competence measurement. It seemed only natural, when this project presented itself, that it should be the next step on the research path.
What problem on the ground is it going to solve?
Hopefully - because our data collection is currently underway - operators' performance will improve because of the detailed feedback our competence measurement tools will give them.
Specifically, the aim is to detect more cases of cancer through colonoscopy.
What is the potential - nationally and internationally?
First of all, dissemination and implementation in the Danish screening programme.
We work closely with surgeon Morten Rasmussen, who heads the national colorectal cancer screening programme. He is very enthusiastic about the project. If it works in Denmark, it also has potential in the rest of the world.
About Kristoffer Mazanti Lund
Kristoffer is a medical doctor and PhD student who has been affiliated with CAMES as a researcher since 2018.
His research activity consists in finding objective and automated measures in surgical skills. By presenting these measures to the operator after each procedure, the goal is to educate and improve our doctors and nurses.
Currently, Kristoffer is investigating whether artificial intelligence feedback can improve the number of precancerous lesions detected in the Danish colorectal cancer screening programme - and thereby reduce mortality from this disease.
See Kristoffer's research profile - and publication lists