Sa1043 Distributing Colonoscopy Quality Report Cards and Implementing Institutional Minimum Standards of Practice Each Significantly Improve Adenoma Detection Rates

Objective. This study aims to investigate the effects of reporting colonoscopy findings and the regular review of outcomes on adenoma detection rates.Methods. Patients who underwent colonoscopy from August 2013 to February 2014 were selected as the intervention group. The preintervention group included patients who underwent colonoscopy from January 2013 to July 2013, in which the procedure sheet for this group of patients was not accomplished. The primary outcome was adenoma detection rate (ADR), and secondary outcomes included the success rate of intubation and withdrawal time.Results. This study included 2,467 cases: 1,302 cases in the intervention group and 1,165 cases in the preintervention group. There was no significant difference in demographic characteristics between the two groups. In the intervention group, withdrawal time of colonoscopy was longer (P<0.01), and the success rate of intubation (92.5% versus 89.1%,P<0.05) and detection rate of polyps (32.6% versus 27.6%,P<0.05) and adenomas (20.0% versus 16.1%,P<0.05) were higher. Significantly high detection rates for proximal adenomas, flat adenomas, and adenomas with a diameter <5 mm were observed in the intervention group (allP<0.01).Conclusion. The reporting and review of procedure details help to improve quality indicators of colonoscopy.

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Effect of Colonoscopy Volume on Quality Indicators

Canadian Journal of Gastroenterology and Hepatology ◽

10.1155/2016/2580894 ◽

2016 ◽

Vol 2016 ◽

pp. 1-7 ◽

Cited By ~ 5

Author(s):

David Pace ◽

Mark Borgaonkar ◽

Muna Lougheed ◽

Curtis Marcoux ◽

Brad Evans ◽

...

Keyword(s):

Case Volume ◽

Detection Rates ◽

Adenoma Detection ◽

Confounding Variables ◽

Significant Difference ◽

Adenoma Detection Rates ◽

Multivariable Regression ◽

Male Sex ◽

Colonoscopy Quality

Background. The purpose of this study is to determine if colonoscopy quality is associated with the annual case volume of endoscopists.Methods. A retrospective cohort study was performed on 3235 patients who underwent colonoscopy in the city of St. John’s, NL, between January and June 2012. Data collected included completion of colonoscopy (CCR) and adenoma detection rates (ADR). Endoscopists were divided into quintiles based on annual case volume. To account for potential confounding variables, univariate analyses followed by multivariable logistic regression were used to identify variables independently associated with CCR and ADR.Results. A total of 13 surgeons and 8 gastroenterologists were studied. There was a significant difference in CCR (p< 0.001) and ADR (p< 0.001) based on annual volume. Following multivariable regression, predictors of successful colonoscopy completion included annual colonoscopy volume, lower age, male sex, an indication of screening or surveillance, and a low ASA score. Predictors of adenoma detection included older age, male sex, an indication of screening or surveillance, and gastroenterology specialty.Conclusion. Higher annual case volume is associated with better quality of colonoscopy in terms of completion. However, gastroenterology specialty appears to be a better predictor of ADR than annual case volume.

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Performance report cards increase adenoma detection rate

Endoscopy International Open ◽

10.1055/s-0043-110568 ◽

2017 ◽

Vol 05 (07) ◽

pp. E675-E682 ◽

Cited By ~ 7

Author(s):

Michael Sey ◽

Andy Liu ◽

Samuel Asfaha ◽

Victoria Siebring ◽

Vipul Jairath ◽

...

Keyword(s):

Detection Rate ◽

Temporal Trends ◽

Adenoma Detection Rate ◽

Report Cards ◽

Polyp Detection ◽

Detection Rates ◽

Polyp Detection Rate ◽

Adenoma Detection ◽

Performance Report ◽

Colonoscopy Quality

Abstract Background and study aims Adenoma detection rate (ADR) is an important measure of colonoscopy quality, as are polyp, advanced ADR, and adenocarcinoma detection rates. We investigated whether performance report cards improved these outcome measures. Patients and methods Endoscopists were given report cards comparing their detection rates to the institutional mean on an annual basis. Detection rates were evaluated at baseline, 1 year after report cards (Year 1), and 2 years after report cards (Year 2). Endoscopists were unaware of the study and received no other interventions. The primary outcome was ADR and secondary outcomes were polyp detection rate (PDR), advanced ADR, and adenocarcinoma detection rate. Multivariate regression was performed to adjust for temporal trends in patient, endoscopists, and procedural factors. Results Seventeen physicians performed 3,118 screening colonoscopies in patients with positive FOBT or family history of colon cancer. The ADR increased from 34.5 % (baseline) to 39.4 % (Year 1) and 41.2 % (Year 2) (P = 0.0037). The PDR increased from 45 % (baseline) to 48.8 % (Year 1) and 51.8 % (Year 2) (P = 0.011). There was no significant improvement in advanced ADR or adenocarcinoma detection rates. On multivariate analysis, the ADR increased by 22 % in Year 1 (P = 0.03) and 30 % in Year 2 (P = 0.008). Among physicians with a baseline ADR < 25 %, improvement in ADR was even greater, increasing 2.2 times by the end of the study (P = 0.004). Improvements in ADR were not correlated with specialty although gastroenterologists were 52 % more likely to find an adenoma than general surgeons. Conclusions Annual performance report cards increased adenoma detection rates, especially among physicians with low ADR < 25 %.

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The analysis of multilevel factors affecting adenoma detection rates for colonoscopies: a large-scale retrospective study

BMC Gastroenterology ◽

10.1186/s12876-021-01983-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Liang Huang ◽

Yue Hu ◽

Shan Liu ◽

Bo Jin ◽

Bin Lu

Keyword(s):

Retrospective Study ◽

Large Scale ◽

Multivariate Regression Analysis ◽

Strongly Correlated ◽

Detection Rates ◽

Factors Affecting ◽

Adenoma Detection ◽

Adenoma Detection Rates ◽

Colonoscopy Quality ◽

The Impact

Abstract Background Adenoma detection rate (ADR) is a validated primary quality indicator for colonoscopy procedures. However, there is growing concern over the variability associated with ADR indicators. Currently, the factors that influence ADRs are not well understood. Aims In this large-scale retrospective study, the impact of multilevel factors on the quality of ADR-based colonoscopy was assessed. Methods A total of 10,788 patients, who underwent colonoscopies performed by 21 endoscopists between January 2019 and December 2019, were retrospectively enrolled in this study. Multilevel factors, including patient-, procedure-, and endoscopist-level characteristics were analyzed to determine their relationship with ADR. Results The overall ADR was 20.21% and ranged from 11.4 to 32.8%. Multivariate regression analysis revealed that higher ADRs were strongly correlated with the following multilevel factors: patient age per stage (OR 1.645; 95% CI 1.577–1.717), male gender (OR 1.959; 95% CI 1.772–2.166), sedation (OR 1.402; 95% CI 1.246–1.578), single examiner colonoscopy (OR 1.330; 95% CI 1.194–1.482) and senior level endoscopists (OR 1.609; 95% CI 1.449–1.787). Conclusion The ADR is positively correlated with senior level endoscopists and single examiner colonoscopies in patients under sedation. As such, these procedure- and endoscopist-level characteristics are important considerations to improve the colonoscopy quality.

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