Managing the Measurement of Colonoscopy Quality

The adenoma detection rate (ADR) is our current best colonoscopy quality indicator, but it is not without limitations. In this issue of the Journal, novel ADR benchmarks are proposed based on historical local colonoscopy results. These minimally acceptable, standard of care, and aspirational benchmarks may encourage continuous quality improvement through the explicit determination of notably higher but proven achievable ADR targets, although validation in clinical practice is needed. Ultimately, we must transition from ADR measurement to the implementation of robust quality improvement processes that assure the best outcomes for our patients.