Variation in Colonoscopy Performance Measures According to Procedure Indication

Autor: Carolina Mangas-Sanjuan, Enrique Santana, Joaquín Cubiella, Elena Rodríguez-Camacho, Agustín Seoane, Marco Antonio Alvarez-Gonzalez, Adolfo Suárez, Verónica Álvarez-García, Natalia González, Alberto Luè, Lucía Cid-Gomez, Marta Ponce, Luis Bujanda, Isabel Portillo, María Pellisé, Pilar Díez-Redondo, Maite Herráiz, Akiko Ono, Ángeles Pizarro, Pedro Zapater, Rodrigo Jover, Juan A. Casellas, Francisco A. Ruíz-Gómez, Eva Serrano, Cristina Mira, Olegario Castaño, Lorena Blanco, Javier Lara, Enrique Quintero, H. Clínic, Liseth Rivero, Josep Llach, Henry Cordova, Isis Araujo, Ariadna Sánchez, Ingrid Ordas, Karina Lisette, H. del Mar, Marco Antonio Álvarez-González, Laura Carot, Inés Ana Ibáñez, Faust Riu, Miguel Pantaleón, Josep María Dedeu, Luis Eugenio Barranco, Franco Baiocchi, Coral Tejido, Isabel Idígoras, Isabel Bilbao, Cristina Carretero, Maite Betés, Marco Bustamante, Vicente Pons, Lidia Argüello, Carla Satorres, Henar Núñez, Victoria Busto, Lucía Cid-Gómez, Vicent Hernández, Luisa de Castro, Nereida Fernández-Fernández, Alfonso Martínez-Turnes, Beatriz Romero-Mosquera, Romina Fernández-Poceiro, Alberto Lué, Ángel Lanas, Angel Ferrández, Pilar Roncales
Rok vydání: 2020
Předmět:
Zdroj: CLINICAL GASTROENTEROLOGY AND HEPATOLOGY
r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
instname
ISSN: 1542-7714
Popis: Background & Aims Most fulfillment and benchmarking information for colonoscopy quality indicators has been obtained from studies of primary screening colonoscopies. We analyzed differences in the fulfillment of colonoscopy quality indicators based on the indication for endoscopy. Methods We performed an observational, multicenter, cross-sectional study of 14,867 patients who underwent endoscopy procedures for gastrointestinal symptoms (40.3%), a positive result from a fecal immunochemical test (36.0%), postpolypectomy surveillance (15.3%), or primary screening (8.4%), from February 2016 through December 2017 at 14 centers in Spain. We evaluated rates of adequate colon cleansing, cecal intubation, adenoma detection, and colorectal cancer detection, among others. We used findings from primary screening colonoscopies as the reference standard. Results Fewer than 90% of patients had adequate bowel preparation; 83.1% of patients with gastrointestinal symptoms had adequate bowel preparation (odds ratio [OR] compared with patients with primary screening colonoscopies, 0.62; 95% CI, 0.49–0.78) and 85.3% of patients receiving postpolypectomy surveillance had adequate bowel preparation (OR, 0.71; 95% CI, 0.55–0.91). The cecal intubation rate was also lower in patients with gastrointestinal symptoms (93.1%) (OR, 0.34; 95% CI, 0.22–0.52). The adenoma detection rate was higher in patients with a positive result from a fecal immunochemical test (46.4%) (OR, 2.01; 95% CI, 1.71–2.35) and in patients undergoing postpolypectomy surveillance (48.2%) (OR, 1.41; 95% CI, 1.20–1.67). The highest proportion of patients with colorectal cancer was in the gastrointestinal symptom group (5.1%) (OR, 5.24; 95% CI, 2.30–11.93) and the lowest was in patients undergoing surveillance (0.8%) (OR, 0.83; 95% CI, 0.32–2.14). Conclusions Fulfillment of colonoscopy performance measures varies substantially by indication. Policies addressing performance measures beyond colonoscopy screening procedures should be developed. Benchmarking recommendations could be adjusted according to colonoscopy indication.
Databáze: OpenAIRE
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