Dutch Gastrointestinal Endoscopy Audit: automated extraction of colonoscopy data for quality assessment and improvement - 21/04/20

Doi : 10.1016/j.gie.2020.01.052

Michael P.M. de Neree tot Babberich, MD, PhD ¹, Michiel Ledeboer, MD, PhD ², Monique E. van Leerdam, MD, PhD ³, Manon C.W. Spaander, MD, PhD ⁴, Aura A.J. van Esch, MD, PhD ⁵, Rob J. Ouwendijk, MD, PhD ⁶, Peter J. van der Schaar, MD, PhD ⁷, Sander van der Beek, MD ⁸, Miangela M. Lacle, MD, PhD ⁹, Paul A. Seegers ¹⁰, Michel W.J. M. Wouters, MD, PhD ¹¹, Paul Fockens, MD, PhD ¹, Evelien Dekker, MD, PhD ^1,^⁎
¹ Department of Gastroenterology & Hepatology, Amsterdam University Medical Centers, Amsterdam, the Netherlands
² Department of Gastroenterology & Hepatology, Deventer Hospital, Deventer, the Netherlands
³ Department of Gastroenterology & Hepatology, Netherlands Cancer Institute, Amsterdam, the Netherlands
⁴ Department of Gastroenterology & Hepatology, Erasmus Medical Center, Rotterdam, the Netherlands
⁵ Department of Gastroenterology & Hepatology, Gelre Hospitals, Apeldoorn, the Netherlands
⁶ Department of Gastroenterology & Hepatology, Bravis Hospital, Roosendaal, the Netherlands
⁷ Department of Gastroenterology & Hepatology, St Antonius Hospital, Nieuwegein, the Netherlands
⁸ Department of Internal Medicine, Rivierenland Hospital, Tiel, the Netherlands
⁹ Department of Pathology, University Medical Center Utrecht, Utrecht, the Netherlands
¹⁰ PALGA Foundation, Houten, the Netherlands
¹¹ Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands

^∗Reprint requests: Evelien Dekker, MD, PhD, Department of Gastroenterology and Hepatology, Amsterdam University Medical Centers, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.Department of Gastroenterology and HepatologyAmsterdam University Medical CentersUniversity of AmsterdamMeibergdreef 9AZ Amsterdam1105The Netherlands

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Tuesday 21 April 2020

Abstract

Background and Aims

The importance of having quality assessment, assurance, and improvement tools in health care is increasingly recognized. However, the additional associated administration burden progressively interferes with the structural implementation and adoption of such tools, especially when it concerns high-volume procedures such as colonoscopies. The development of the Dutch Gastrointestinal Endoscopy Audit (DGEA), a registry with automated extraction of colonoscopy quality data, and its first results are described.

Methods

In close cooperation with commercial endoscopy reporting systems and a national histopathology database, healthcare professionals performing colonoscopies initiated a quality registry that extracts data from its core hospital resource or histology database without manual interference of the healthcare providers. Data extracted consisted of patient age, gender, indication of the colonoscopy, American Society of Anesthesiologists score, Boston Bowel Preparation Score, and cecal intubation; for the colonoscopy after a positive fecal immunochemical test in the colorectal cancer screening program, other data were polyp detection rate, which was available for all 48 hospitals or endoscopy centers, and adenoma detection rate, which was available for 26 hospitals or endoscopy centers.

Results

Between January 1, 2016 and March 31, 2019, 48 hospitals or endoscopy centers voluntarily participated in the DGEA, and 275,017 unique patients with 313,511 colonoscopies were registered. Overall missing values were limited to <1%.

Conclusions

The results of this study demonstrate that it is feasible to deploy a quality registry collecting uniform data without additional administration burden for healthcare professionals.

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Abbreviations : ADR, ASA, BBPS, CIR, CRC, DGEA, DICA, FIT, PCCRC, PDR, TTP

Plan

DISCLOSURE: The following authors disclosed financial relationships: P. Fockens: Consultant for Olympus, Cook Medical, and Ethicon Endosurgery. E. Dekker: Consultant for Fujifilm, Tillots, GI Supply, and CPP-FAP; speaker for Olympus, Roche, and GI Supply; equipment loan and research grant from Fujifilm; supervisory board for eNose. All other authors disclosed no financial relationships.