ADENOMA DETECTION RATE CORRELATIONS WITH SECONDARY COLONOSCOPY QUALITY INDICATORS

Background. Quality indicators for colonoscopy have been developed, but the uptake of these metrics into practice is uncertain. Our aims were to assess physician perceptions regarding colonoscopy quality measurement and to quantify the perceived impact of quality measurement on clinical practice.Methods. We conducted in-person interviews with 15 gastroenterologists about their perceptions regarding colonoscopy quality. Results from these interviews informed the development of a 34-question web-based survey that was emailed to 1,500 randomlyselected members of the American College of Gastroenterology.Results. 160 invitations were undeliverable, and 167 out of 1340 invited physicians (12.5%) participated in the survey. Respondents and nonrespondents did not differ in age, sex, practice setting, or years since training. 38.8% of respondents receive feedback on their colonoscopy quality. The majority of respondents agreed with the use of completion rate (90%) and adenoma detection rate (83%) as quality indicators but there was less enthusiasm for withdrawal time (61%). 24% of respondents reported usually or always removing diminutive polyps solely to increase their adenoma detection rate, and 20% reported prolonging their procedure time to meet withdrawal time standards.Conclusions. A minority of respondents receives feedback on the quality of their colonoscopy. Interventions to increase continuous quality improvement in colonoscopy screening are needed.

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Optimized Sedation Improves Colonoscopy Quality Long-Term

Gastroenterology Research and Practice ◽

10.1155/2015/195093 ◽

2015 ◽

Vol 2015 ◽

pp. 1-9 ◽

Cited By ~ 11

Author(s):

Konstantinos Triantafyllou ◽

Athanasios D. Sioulas ◽

Theodora Kalli ◽

Nikolaos Misailidis ◽

Dimitrios Polymeros ◽

...

Keyword(s):

Quality Indicators ◽

Detection Rate ◽

Completion Rate ◽

Adenoma Detection Rate ◽

Completion Rates ◽

Early Complications ◽

Adenoma Detection ◽

Colonoscopy Quality ◽

Complications Rate

Background. Quality monitoring and improvement is prerequisite for efficient colonoscopy.Aim. To assess the effects of increased sedation administration on colonoscopy performance.Materials and Methods. During Era 1 we prospectively measured four colonoscopy quality indicators: sedation administration, colonoscopy completion rate, adenoma detection rate, and early complications rate in three cohorts: cohort A: intention for total colonoscopy cases; cohort B: cohort A excluding bowel obstruction cases; cohort C: CRC screening-surveillance cases within cohort B. We identified deficiencies and implemented our plan to optimize sedation. We prospectively evaluated its effects in both short- (Era 2) and long-term period (Era 3).Results. We identified that sedation administration and colonoscopy completion rates were below recommended standards. After sedation optimization its use rate increased significantly (38.1% to 55.8% to 69.5%) and colonoscopy completion rate increased from 88.3% to 90.6% to 96.4% in cohort B and from 93.2% to 95.3% to 98.3% in cohort C, in Eras 1, 2, and 3, respectively. Adenoma detection rate increased in cohort C (25.9% to 30.6% to 35%) and early complications rate decreased from 3.4% to 1.9% to 0.3%. Most endoscopists increased significantly their completion rate and this was preserved long-term.Conclusion. Increased sedation administration results in long-lasting improvement of colonoscopy quality indicators.

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