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Recommendations for Quality Colonoscopy Reporting for Patients with Inflammatory Bowel Disease: Results from a RAND
Shane M Devlin1, Gil Y Melmed, Peter M Irving
1*The University of Calgary, Calgary, Alberta, Canada; †Cedars-Sinai Medical Center, Los Angeles, California; ‡Inflammatory Bowel Disease Centre, Guy's and St. Thomas' Hospitals, London, United Kingdom; §Department of Medicine, Inflammatory Bowel Disease Center, The University of Chicago, Chicago, Illinois; ‖Dr. Henry D. Janowitz Division of Gastroenterology, Mount Sinai School of Medicine, New York, New York; ¶Jefferson University, Philadelphia, Pennsylvania; **Mayo Clinic, Rochester, MN; ††University of California San Francisco, San Francisco, California; ‡‡Department of Gastroenterology, The Alfred Hospital, Melbourne, Australia; §§University of Pittsburgh, Pittsburgh, Pennsylvania; ‖‖University of British Columbia, Vancouver, British Columbia, Canada; ¶¶Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts; ***Dalhousie University, Halifax, Nova Scotia, Canada; and †††Inflammatory Bowel Disease Centre, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
Background:
Consensus on what constitutes a quality colonoscopy report for patients with inflammatory bowel disease (IBD) is lacking. We developed a template for quality colonoscopy reporting that can be used broadly by endoscopists.
Methods:
After a literature review of topics relevant to colonoscopy reporting, members of the Building Research in Inflammatory Bowel Disease Globally (BRIDGe) group and 2 external experts proposed candidate reporting elements. The RAND/University of California, Los Angeles appropriateness method was applied to rate the importance and feasibility of elements for inclusion in colonoscopy reports for patients with IBD. Panelists used the modified Delphi method to anonymously rate the importance and feasibility of candidate elements on a 1-to-9 scale (1-3: not important/feasible, 4-6: moderately important/feasible, 7-9: very important/feasible). Disagreement was assessed using a validated index. The panelists then met in person for discussion followed by a second round of voting. Elements rated a median of 7 or higher on importance after rerating were retained.
Results:
One hundred two reporting elements were proposed. A total of 48 elements were retained across the four themes of "disease background," "findings and interventions," "Crohn's disease with an ileocolonic anastomosis," and "pouchoscopy."
Conclusions:
A comprehensive list of recommended elements for quality IBD colonoscopy reporting stratified by clinical scenario has been described, using a rigorous and evidence-based approach. These elements can be incorporated into endoscopy reporting software platforms. Standardized endoscopy reporting may improve the quality of care in IBD.
