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Variation in Colonoscopy Performance Measures According to Procedure Indication.

Carolina Mangas-Sanjuan1, Enrique Santana1, Joaquín Cubiella2

  • 1Department of Gastroenterology, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria and Biomédica de Alicante, ISABIAL, Alicante, Spain.

Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association
|August 26, 2019
PubMed
Summary

Colonoscopy quality indicators differ significantly based on the reason for the procedure. Quality benchmarks should be adjusted for different indications beyond primary screening to improve patient care.

Keywords:
ADRColon CancerComparisonFIT

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Area of Science:

  • Gastroenterology
  • Clinical Quality Improvement
  • Health Services Research

Background:

  • Colonoscopy quality indicators are often based on primary screening procedures.
  • There is a need to understand how quality indicators vary by the indication for colonoscopy.

Purpose of the Study:

  • To analyze differences in the fulfillment of colonoscopy quality indicators based on the indication for endoscopy.

Main Methods:

  • An observational, multicenter, cross-sectional study of 14,867 patients undergoing colonoscopy.
  • Data collected from February 2016 to December 2017 across 14 Spanish centers.
  • Evaluated quality indicators including bowel preparation, cecal intubation, adenoma detection, and colorectal cancer detection rates, using primary screening as the reference.

Main Results:

  • Adequate bowel preparation was less common in patients with gastrointestinal symptoms (83.1%) and those undergoing postpolypectomy surveillance (85.3%) compared to primary screening.
  • Cecal intubation rates were lower for patients with gastrointestinal symptoms (93.1%).
  • Adenoma detection rates were higher in patients with positive fecal immunochemical tests (46.4%) and postpolypectomy surveillance (48.2%). Colorectal cancer detection was highest in the gastrointestinal symptom group (5.1%).

Conclusions:

  • Colonoscopy performance measures vary significantly depending on the indication for the procedure.
  • Performance benchmarking and quality improvement policies should consider the specific indication for colonoscopy, not just screening.
  • Recommendations for quality indicators may need adjustment for different colonoscopy indications.