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Assessing performance of colonoscopy procedures improves quality
Date:6/21/2013

first part of the large intestine or colon), and adenoma detection rates, adjusted for physician, patient age, and sex. Multivariable logistic regression was performed to determine factors associated with adenoma detection. The procedures were performed by six board certified gastroenterologists or colorectal surgeons, or by GI fellows under direct supervision of these attendings.

Results

A total of 928 patients (male 93 percent, white 78 percent) were included (pre-intervention 336; post-intervention 592). There were no significant differences in patient age, sex, smoking status, body mass index, bowel preparation quality, colonoscope model, and proportion of colonoscopies performed with a trainee between the pre-intervention and post-intervention phases. In the post-intervention phase, the adjusted adenoma detection rate and cecal intubation rates were significantly higher: 53.9 percent versus 44.7 percent and 98.1 percent versus 95.6 percent, respectively. A higher trend in ADR detection in the intervention phase was found for five of the six physicians. The increment in ADR was due mostly to increased detection of proximal adenomas. These are polyps on the right side of the colon which are often more difficult to detect and have been implicated as an important factor in the efficacy of colonoscopy for colon cancer screening. There were no significant changes in serrated polyp detection, advanced neoplasm detection, number of adenomas detected per colonoscopy, and mean size of adenomas after implementation of the intervention. The report card intervention remained significantly associated with higher ADRs after adjustment for patient age, sex and physician.

The researchers concluded that a quarterly report card was associated with improved colonoscopy quality indicators. They stated that this intervention is practical to generate and implement, and it may serve as a model for quality improvement programs in different patient and
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Contact: Anne Brownsey
abrownsey@asge.org
630-570-5635
American Society for Gastrointestinal Endoscopy
Source:Eurekalert

Page: 1 2 3 4

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