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Pilot Validation Study: Canadian Global Rating Scale for Colonoscopy Services.

Stéphanie Carpentier1, Nour Sharara1, Alan N Barkun2

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Summary

The Canadian Global Rating Scale (GRS-C) for digestive endoscopy quality shows good validity and reliability. This tool supports national initiatives to enhance endoscopy unit processes.

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Area of Science:

  • Gastroenterology
  • Health Services Research
  • Medical Quality Improvement

Background:

  • The United Kingdom Global Rating Scale (GRS-UK) is a validated tool for assessing digestive endoscopy unit-level quality metrics.
  • The Canadian Association of Gastroenterology (CAG) endorsed the development of a Canadian version, the GRS-C.

Purpose of the Study:

  • To evaluate the psychometric properties of the Canadian Global Rating Scale (GRS-C).
  • To assess the validity, reliability, and responsiveness to change of the GRS-C in Canadian endoscopy units.

Main Methods:

  • Prospective data were collected from three Canadian endoscopy units.
  • Physician, nurse, and administrative personnel responses were analyzed.
  • GRS-C items were compared against national CAG quality guidelines and GRS-UK statements.

Main Results:

  • Face validity was confirmed by respondent identification of GRS-C item themes.
  • Content validity was supported, with 78% of key CAG quality indicators addressed by GRS-C.
  • High concordance (75-100%) was found between GRS-C and GRS-UK ratings.
  • Test-retest reliability showed Kappa scores from 0.60-0.83.
  • Responsiveness to change was significant (P < 0.001) at 6 months post-intervention in two units.

Conclusions:

  • The GRS-C demonstrates satisfactory psychometric properties for use in quality improvement initiatives.
  • The GRS-C can support national efforts to improve digestive endoscopy unit processes.
  • Further multi-unit data collection and patient outcome linkage are recommended to confirm GRS-C's impact on patient care.