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Performance report cards increase adenoma detection rate.

Michael Sai Lai Sey1, Andy Liu2, Samuel Asfaha1,3

  • 1Division of Gastroenterology, Department of Medicine, Western University, London, Ontario, Canada.

Endoscopy International Open
|July 11, 2017
PubMed
Summary
This summary is machine-generated.

Annual performance report cards significantly improved adenoma detection rates (ADR) in colonoscopies, particularly for endoscopists with lower baseline ADR. This quality improvement measure enhanced polyp detection but not advanced adenoma or cancer detection.

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Area of Science:

  • Gastroenterology
  • Medical Quality Improvement
  • Endoscopic Procedures

Background:

  • Adenoma detection rate (ADR) is a key metric for colonoscopy quality.
  • Other important measures include polyp, advanced ADR, and adenocarcinoma detection rates.

Purpose of the Study:

  • To evaluate if performance report cards enhance key colonoscopy quality outcome measures.
  • To assess the impact of report cards on adenoma detection rate (ADR) and other detection rates.

Main Methods:

  • Endoscopists received annual report cards comparing their detection rates to the institutional average.
  • Detection rates were assessed at baseline, Year 1, and Year 2 post-intervention.
  • Multivariate regression adjusted for patient, endoscopist, and procedural factors.

Main Results:

  • Adenoma detection rate (ADR) increased significantly from baseline (34.5%) to Year 2 (41.2%) (P=0.0037).
  • Polyp detection rate (PDR) also showed significant improvement.
  • Physicians with baseline ADR < 25% experienced a 2.2-fold increase in ADR by study end (P=0.004).

Conclusions:

  • Annual performance report cards are effective in improving adenoma detection rates.
  • The improvement was most pronounced among endoscopists with initially low ADR.
  • No significant improvements were observed in advanced ADR or adenocarcinoma detection rates.