Diagnostic Yield Variation with Colonoscopy among Pediatric Endoscopists.

Area of Science:

• Pediatric Gastroenterology
• Endoscopic Procedures
• Diagnostic Yield Analysis

Background:

• Assessing provider variation in diagnostic yield is critical for pediatric endoscopy centers.
• Secondary aims included evaluating ileal intubation rates and procedural complications.

Purpose of the Study:

• To determine provider variation in diagnostic yield during pediatric colonoscopies.
• To examine provider-level ileal intubation rates and procedural complications.

Main Methods:

• Retrospective review of 374 pediatric patients undergoing colonoscopy before June 2018.
• Defined diagnostic yield as the combination of endoscopically abnormal (EA) and isolated histologically abnormal (IHA) colonoscopies.

Main Results:

• Significant variability in diagnostic yield among 16 clinicians (22%–86%), with an overall yield of 48%.
• Abnormal calprotectin (83%) and blood tests (65%) correlated with higher yields; symptoms like abdominal pain (39%) had lower yields.
• Average ileal intubation rate was 90%, with 6% having an EA ileum and 4% an IHA ileum in patients with a normal colon.

Conclusions:

• Individual variability in diagnostic yield and ileal intubation exists within pediatric gastroenterology practices.
• Recommended goals include >90% ileal intubation rates and >40% provider diagnostic yields.