Time trends in quality indicators of colonoscopy

Area of Science:

• Gastroenterology
• Health Services Research
• Quality Improvement

Background:

• Colonoscopy quality varies significantly.
• The Gastronet program in Norway aims to improve colonoscopy performance through annual feedback.
• This study analyzes trends in colonoscopy quality indicators within Gastronet.

Purpose of the Study:

• To analyze trends of key quality indicators for colonoscopy within the Gastronet program.
• To evaluate the impact of the Gastronet quality assurance program on colonoscopy performance.

Main Methods:

• Prospective cohort study of 73,522 outpatient colonoscopies (2003-2012).
• Multivariate logistic regression used to analyze annual trends.
• Key indicators: cecal intubation rate, procedure pain, and polyp detection (≥5mm).

Main Results:

• Severely painful colonoscopies decreased by 38% (OR=0.92/year, p=0.045).
• Cecal intubation rates remained unchanged (OR=0.99/year, p=0.6).
• Polyp detection rates showed no significant change (OR=1.03/year, p=0.15).

Conclusions:

• Gastronet participation correlated with a significant reduction in colonoscopy-related pain.
• Cecal intubation and polyp detection rates were unaffected by Gastronet participation.
• Observed improvements in pain may be due to the audit or technological advancements.