Recently, usage of the term ‘heart failure with preserved ejection fraction (HFpEF)’ has predominated over the term ‘diastolic heart failure (DHF).’ The term ‘preserved ejection fraction’ represents only one aspect of DHF and does not provide insight into the hemodynamic mechanism of heart failure. In heart failure with reduced ejection fraction (HFrEF), depressed ejection fraction is the independent determinant of prognosis regardless of etiology. However, in HFpEF, because the prognosis is predominantly determined by etiologies of HFpEF, results of the drug on the prognosis in the clinical trial cannot be interpreted as it is. Therefore, studies on patients with HFpEF should be restricted to patients with diastolic dysfunction and, effects of drugs should be focused on symptom improvement not survival benefit. One reason for the prevalent use of HFpEF over DHF is the complexity in assessing diastolic function. Current official recommendations for the evaluation of diastolic function are too complex to be widely applied in the patient enrollment in large clinical trials as well as not easily applicable in our daily clinical practice. Therefore, there is a clinical need for a simple and practical way of assessing diastolic function.

Recently, usage of the term ‘heart failure with preserved ejection fraction (HFpEF)’ has predominated over the term ‘diastolic heart failure (DHF).’ The term ‘preserved ejection fraction’ represents only one aspect of DHF and does not provide insight into the hemodynamic mechanism of heart failure. In heart failure with reduced ejection fraction (HFrEF), depressed ejection fraction is the independent determinant of prognosis regardless of etiology. However, in HFpEF, because the prognosis is predominantly determined by etiologies of HFpEF, results of the drug on the prognosis in the clinical trial cannot be interpreted as it is. Therefore, studies on patients with HFpEF should be restricted to patients with diastolic dysfunction and, effects of drugs should be focused on symptom improvement not survival benefit. One reason for the prevalent use of HFpEF over DHF is the complexity in assessing diastolic function. Current official recommendations for the evaluation of diastolic function are too complex to be widely applied in the patient enrollment in large clinical trials as well as not easily applicable in our daily clinical practice. Therefore, there is a clinical need for a simple and practical way of assessing diastolic function.

Recently, usage of the term ‘heart failure with preserved ejection fraction (HFpEF)’ has predominated over the term ‘diastolic heart failure (DHF).’ The term ‘preserved ejection fraction’ represents only one aspect of DHF and does not provide insight into the hemodynamic mechanism of heart failure. In heart failure with reduced ejection fraction (HFrEF), depressed ejection fraction is the independent determinant of prognosis regardless of etiology. However, in HFpEF, because the prognosis is predominantly determined by etiologies of HFpEF, results of the drug on the prognosis in the clinical trial cannot be interpreted as it is. Therefore, studies on patients with HFpEF should be restricted to patients with diastolic dysfunction and, effects of drugs should be focused on symptom improvement not survival benefit. One reason for the prevalent use of HFpEF over DHF is the complexity in assessing diastolic function. Current official recommendations for the evaluation of diastolic function are too complex to be widely applied in the patient enrollment in large clinical trials as well as not easily applicable in our daily clinical practice. Therefore, there is a clinical need for a simple and practical way of assessing diastolic function.

Recently, usage of the term ‘heart failure with preserved ejection fraction (HFpEF)’ has predominated over the term ‘diastolic heart failure (DHF).’ The term ‘preserved ejection fraction’ represents only one aspect of DHF and does not provide insight into the hemodynamic mechanism of heart failure. In heart failure with reduced ejection fraction (HFrEF), depressed ejection fraction is the independent determinant of prognosis regardless of etiology. However, in HFpEF, because the prognosis is predominantly determined by etiologies of HFpEF, results of the drug on the prognosis in the clinical trial cannot be interpreted as it is. Therefore, studies on patients with HFpEF should be restricted to patients with diastolic dysfunction and, effects of drugs should be focused on symptom improvement not survival benefit. One reason for the prevalent use of HFpEF over DHF is the complexity in assessing diastolic function. Current official recommendations for the evaluation of diastolic function are too complex to be widely applied in the patient enrollment in large clinical trials as well as not easily applicable in our daily clinical practice. Therefore, there is a clinical need for a simple and practical way of assessing diastolic function.

Purpose: This study introduced adenomas per polypectomy (APP) as a novel metric for evaluating the progression of lesion discrimination skills among colonoscopy trainees. Methods: This retrospective study was conducted at the National Cancer Center, Korea between March 2020 and February 2023. Nine colorectal surgeons who completed a structured 1-year colonoscopy training program were included, and their performance was compared with that of 5 expert endoscopists. APP was defined as the number of histologically confirmed adenomas among the total number of polypectomies performed. The APPs were calculated serially to assess changes from the beginning to the end of the training. Results: A total of 8,072 colonoscopies were performed by 9 trainees and 11,687 by 5 experts. The average APP of the 9 trainees was 67.0%, which was significantly different from the 73.9% APP of the experts (P < 0.001). The APP progression of trainees exhibited 3 phases: phase 1 (<200 cases) showed increasing polyp detection and APP; phase 2 (200–500 cases) displayed a sharp rise in the number of polypectomies but a decline in APP; and phase 3 (>500 cases) demonstrated a decrease in the number of polypectomies with a moderate rise in APP. However, even in phase 3, the trainees’ APP remained significantly lower than that of the experts (69.9% vs. 73.9%, P = 0.027). Conclusion APP, a measure of visual adenoma discrimination ability, undergoes 3 stages of progression during colonoscopy training. This progression suggests that the APP may serve as an additional metric for assessing the effectiveness of colonoscopy training.

Purpose: To analyze adenoma detection rate (ADR) and related quality indicators of colonoscopy among trainees and make recommendations for appropriate colonoscopy training. Methods: ADR and related indicators of colonoscopies performed by 3 trainees and 5 colonoscopy experts between March and November 2022 were analyzed. These indicators were analyzed in both the entire patients and the screening/surveillance group. In addition, the training period of the 3 trainees was divided into 3 sections, and the changes in these indicators were examined. Results: The mean ADR of the 3 trainees was 50.6%. In the screening/surveillance group, the mean ADR of the 3 trainees was 51.8%, showing no significant difference from the experts' ADR (53.4%). When the training period was divided into 3 sections and analyzed in the screening/surveillance group, the mean ADR of the trainees gradually increased to 49.4%, 52.6%, and 53.6%, respectively; however, the difference was insignificant. Analyzing each trainee’s ADR, there was a significant difference among the 3 trainees (58.5% vs. 44.7% vs. 50.2%, P=0.008). However, in the third section of the training period, the 3 trainees’ ADRs were 53.0%, 49.2%, and 57.3%, respectively, showing no significant difference (P=0.606). Conclusion In the early stages of training, the ADR was higher than recommended; however, there were variances in ADR between individuals. As the training period passed, the ADR became similar at the expert level, whereas the difference in ADR between trainees decreased. Therefore, efforts to increase ADR should be made actively from the beginning of training and continued during the training period.

Purpose: To analyze adenoma detection rate (ADR) and related quality indicators of colonoscopy among trainees and make recommendations for appropriate colonoscopy training. Methods: ADR and related indicators of colonoscopies performed by 3 trainees and 5 colonoscopy experts between March and November 2022 were analyzed. These indicators were analyzed in both the entire patients and the screening/surveillance group. In addition, the training period of the 3 trainees was divided into 3 sections, and the changes in these indicators were examined. Results: The mean ADR of the 3 trainees was 50.6%. In the screening/surveillance group, the mean ADR of the 3 trainees was 51.8%, showing no significant difference from the experts' ADR (53.4%). When the training period was divided into 3 sections and analyzed in the screening/surveillance group, the mean ADR of the trainees gradually increased to 49.4%, 52.6%, and 53.6%, respectively; however, the difference was insignificant. Analyzing each trainee’s ADR, there was a significant difference among the 3 trainees (58.5% vs. 44.7% vs. 50.2%, P=0.008). However, in the third section of the training period, the 3 trainees’ ADRs were 53.0%, 49.2%, and 57.3%, respectively, showing no significant difference (P=0.606). Conclusion In the early stages of training, the ADR was higher than recommended; however, there were variances in ADR between individuals. As the training period passed, the ADR became similar at the expert level, whereas the difference in ADR between trainees decreased. Therefore, efforts to increase ADR should be made actively from the beginning of training and continued during the training period.

Purpose: To analyze adenoma detection rate (ADR) and related quality indicators of colonoscopy among trainees and make recommendations for appropriate colonoscopy training. Methods: ADR and related indicators of colonoscopies performed by 3 trainees and 5 colonoscopy experts between March and November 2022 were analyzed. These indicators were analyzed in both the entire patients and the screening/surveillance group. In addition, the training period of the 3 trainees was divided into 3 sections, and the changes in these indicators were examined. Results: The mean ADR of the 3 trainees was 50.6%. In the screening/surveillance group, the mean ADR of the 3 trainees was 51.8%, showing no significant difference from the experts' ADR (53.4%). When the training period was divided into 3 sections and analyzed in the screening/surveillance group, the mean ADR of the trainees gradually increased to 49.4%, 52.6%, and 53.6%, respectively; however, the difference was insignificant. Analyzing each trainee’s ADR, there was a significant difference among the 3 trainees (58.5% vs. 44.7% vs. 50.2%, P=0.008). However, in the third section of the training period, the 3 trainees’ ADRs were 53.0%, 49.2%, and 57.3%, respectively, showing no significant difference (P=0.606). Conclusion In the early stages of training, the ADR was higher than recommended; however, there were variances in ADR between individuals. As the training period passed, the ADR became similar at the expert level, whereas the difference in ADR between trainees decreased. Therefore, efforts to increase ADR should be made actively from the beginning of training and continued during the training period.

Purpose: To analyze adenoma detection rate (ADR) and related quality indicators of colonoscopy among trainees and make recommendations for appropriate colonoscopy training. Methods: ADR and related indicators of colonoscopies performed by 3 trainees and 5 colonoscopy experts between March and November 2022 were analyzed. These indicators were analyzed in both the entire patients and the screening/surveillance group. In addition, the training period of the 3 trainees was divided into 3 sections, and the changes in these indicators were examined. Results: The mean ADR of the 3 trainees was 50.6%. In the screening/surveillance group, the mean ADR of the 3 trainees was 51.8%, showing no significant difference from the experts' ADR (53.4%). When the training period was divided into 3 sections and analyzed in the screening/surveillance group, the mean ADR of the trainees gradually increased to 49.4%, 52.6%, and 53.6%, respectively; however, the difference was insignificant. Analyzing each trainee’s ADR, there was a significant difference among the 3 trainees (58.5% vs. 44.7% vs. 50.2%, P=0.008). However, in the third section of the training period, the 3 trainees’ ADRs were 53.0%, 49.2%, and 57.3%, respectively, showing no significant difference (P=0.606). Conclusion In the early stages of training, the ADR was higher than recommended; however, there were variances in ADR between individuals. As the training period passed, the ADR became similar at the expert level, whereas the difference in ADR between trainees decreased. Therefore, efforts to increase ADR should be made actively from the beginning of training and continued during the training period.

Purpose: To analyze adenoma detection rate (ADR) and related quality indicators of colonoscopy among trainees and make recommendations for appropriate colonoscopy training. Methods: ADR and related indicators of colonoscopies performed by 3 trainees and 5 colonoscopy experts between March and November 2022 were analyzed. These indicators were analyzed in both the entire patients and the screening/surveillance group. In addition, the training period of the 3 trainees was divided into 3 sections, and the changes in these indicators were examined. Results: The mean ADR of the 3 trainees was 50.6%. In the screening/surveillance group, the mean ADR of the 3 trainees was 51.8%, showing no significant difference from the experts' ADR (53.4%). When the training period was divided into 3 sections and analyzed in the screening/surveillance group, the mean ADR of the trainees gradually increased to 49.4%, 52.6%, and 53.6%, respectively; however, the difference was insignificant. Analyzing each trainee’s ADR, there was a significant difference among the 3 trainees (58.5% vs. 44.7% vs. 50.2%, P=0.008). However, in the third section of the training period, the 3 trainees’ ADRs were 53.0%, 49.2%, and 57.3%, respectively, showing no significant difference (P=0.606). Conclusion In the early stages of training, the ADR was higher than recommended; however, there were variances in ADR between individuals. As the training period passed, the ADR became similar at the expert level, whereas the difference in ADR between trainees decreased. Therefore, efforts to increase ADR should be made actively from the beginning of training and continued during the training period.