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Related Concept Videos

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Related Experiment Video

Updated: Aug 4, 2025

Structured Approach to Colonoscopy Technique Optimization: A Single-Center Experience with Novice Endoscopists
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High quality colonoscopy: using textbook process as a composite quality measure.

Karlijn J Nass1, Sascha C van Doorn2, Paul Fockens1,3

  • 1Department of Gastroenterology and Hepatology, Research Institute Amsterdam Gastroenterology and Metabolism, Amsterdam University Medical Center, Amsterdam, The Netherlands.

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Summary
This summary is machine-generated.

A new "textbook process" (TP) measure for colonoscopy quality was established. TP was achieved in 72.5% of procedures, but significant variation existed between endoscopists, highlighting its potential for quality assessment.

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Area of Science:

  • Gastroenterology
  • Medical Quality Assurance
  • Endoscopic Procedures

Background:

  • High-quality colonoscopy is crucial for patient outcomes.
  • "Textbook outcome" is an established quality measure.
  • A "textbook process" (TP) measure for colonoscopy needs evaluation.

Purpose of the Study:

  • To establish the "textbook process" (TP) as a composite measure for optimal colonoscopy.
  • To assess TP achievement rates in clinical practice.
  • To evaluate variations in TP attainment among endoscopists.

Main Methods:

  • International experts defined TP through a modified Delphi consensus process.
  • TP achievement was applied to prospectively collected data from two endoscopy services.
  • Data from 8227 colonoscopies (Jan 2018 - Aug 2021) were retrospectively analyzed.

Main Results:

  • TP was defined by 8 key quality indicators, including indication, cecal intubation, bowel prep, withdrawal time, patient comfort, surveillance recommendations, and absence of adverse events.
  • TP was achieved in 72.5% of colonoscopies.
  • Significant variation in TP attainment was observed among 48 endoscopists, ranging from 41.0% to 89.1%.

Conclusions:

  • The study proposes "textbook process" (TP) as a novel composite measure for colonoscopy quality.
  • TP provides a comprehensive performance summary.
  • The significant inter-endoscopist variation in TP attainment suggests its utility in quality assessment programs.