Original articleClinical endoscopyImpact of a quarterly report card on colonoscopy quality measures
Section snippets
Methods
The study was approved by the Institutional Review Board at Indiana University-Purdue University at Indianapolis and by the Richard L. Roudebush Veterans Affairs Medical Center Research and Development Committee. We conducted a retrospective review of screening colonoscopies performed at the Medical Center between July 1, 2008 and March 31, 2011. Data sources included the Medical Center GI endoscopy electronic database (ProVation Medical; Minneapolis, Minn), and the Veterans Affairs Vista
Results
During the study time frame, a total of 928 average-risk patients underwent eligible screening colonoscopies by 6 attending physicians. Characteristics of the patients and procedures performed are listed in Table 1. The majority of patients were male (93%) and white (78%), with a mean (± SD) age of 59.8 ± 7 years and mean (± SD) body mass index of 30.5 ± 6.6. The prevalence of smoking was 31%. There were 336 before-intervention colonoscopies and 592 intervention-phase colonoscopies. There were
Discussion
In this study, conducted within a group of endoscopists at a university-affiliated, Veterans Affairs medical center, a quarterly report card was independently associated with improved colonoscopy quality indicators. The overall adjusted ADR for the 6 endoscopists increased from 44.7% to 53.9%, whereas the cecal intubation rate increased from 95.6% to 98.1%. These two metrics are validated measures of colonoscopy performance quality. In a large study that used data from the Ontario Cancer
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2022, Gastrointestinal Endoscopy Clinics of North AmericaCitation Excerpt :Notably, colonoscopists with lower baseline ADRs derived greater benefit from this intervention compared with colonoscopists with higher baseline ADRs (RR: 1.62, 95% CI: 1.18–2.23 compared with RR: 1.06, CI: 0.99–1.13, respectively). While one single-center study also showed improvement in cecal intubation rates from 95.6% to 98.1% with quarterly report cards,53 there was no significant improvement in cecal intubation rate nor WT in a larger meta-analysis.52 Establishing minimum standards of practice alongside report card feedback may also augment ADR improvement.54
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DISCLOSURE: Supported in part by the Cordelia Collins Research Fund (C. Kahi). No other financial relationships relevant to this publication were disclosed.
If you would like to chat with an author of this article, you may contact Dr Kahi at [email protected].