Nationally Automated Colonoscopy Performance Feedback Increases Polyp Detection: The NED APRIQOT Randomized...

Area of Science:

• Gastroenterology
• Medical Quality Improvement
• Health Services Research

Background:

• Higher postcolonoscopy colorectal cancer rates are linked to lower endoscopist polyp detection.
• The UK's National Endoscopy Database (NED) offers real-time data for performance assessment.

Purpose of the Study:

• To evaluate if providing feedback on case-mix-adjusted mean number of polyps (aMNP) improves endoscopist performance.
• To assess the impact of a theory-informed, evidence-based audit and feedback intervention.

Main Methods:

• A multicenter, prospective trial randomized endoscopy centers to an intervention or control group.
• Intervention arm endoscopists received monthly automated performance reports via email.
• The primary outcome measured was endoscopists' aMNP during a 9-month intervention period.

Main Results:

• The intervention group showed a nonsignificant 7% increase in aMNP compared to the control group.
• Unadjusted mean number of polyps (MNP) and polyp detection rate significantly increased by 10% in the intervention arm.
• Endoscopists actively accessing performance reports showed higher aMNP; improvements were not sustained post-intervention.

Conclusions:

• Automated feedback did not significantly increase aMNP, but improved MNP and polyp detection rates.
• Endoscopist engagement with feedback is crucial for effectiveness.
• Future research should focus on sustained engagement and continuous feedback mechanisms.