Polypectomy rate as a quality measure for colonoscopy - 11/08/11
Reprint requests: Douglas O. Faigel, MD, FASGE, Division of Gastroenterology and Hepatology, Mayo Clinic in Arizona, 13400 E Shea Blvd, Scottsdale, AZ 85259Résumé |
Background |
The adenoma detection rate (ADR) has been proposed as a robust quality indicator for colonoscopy, but it is cumbersome to calculate and not available at the time of colonoscopy.
Objective |
To determine whether endoscopists' polypectomy rates (PRs) correlate with their ADRs and to calculate benchmark PRs that correlate with benchmark ADRs.
Design |
Retrospective study.
Setting |
University and Veterans Affairs endoscopy units in Portland, Oregon.
Subjects |
Fifteen endoscopists and their patients.
Main Outcome Measurements |
Proportion of patients with any adenoma and any polyp removed; correlation between ADRs and PRs.
Results |
Fifteen endoscopists performed 2706 average-risk screening colonoscopies during the study. There was variation in the ADR for men (15.4%-44.7%) and women (6.1%-25.8%) and in the PRs for men (17.9%-66.0%) and women (11.3%-43.1%). Endoscopists' PRs correlated well with their ADRs (rs = 0.86, P < .001). To attain the established benchmark ADRs for men (25%) and women (15%), endoscopists needed PRs of 40% and 30%, respectively. Endoscopists attaining the benchmark PRs had a higher ADR among men (32.1% vs 18.4%, P < .001) and a higher ADR among women (21.0% vs 9.8%, P = .01) than those who did not.
Limitations |
Study endoscopists' approach to polypectomy may differ from that of endoscopists in other settings.
Conclusions |
The PR is a useful quality measure with a high degree of correlation with the ADR.
Le texte complet de cet article est disponible en PDF.Abbreviations : ADR, OHSU, PVAMC, PR
Plan
| DISCLOSURE: All authors disclosed no financial relationships relevant to this publication. |
|
| See CME section; page 575. |
Vol 73 - N° 3
P. 498-506 - mars 2011 Retour au numéro
Article précédent
- Application of a conversion factor to estimate the adenoma detection rate from the polyp detection rate
- Dawn L. Francis, Daniel T. Rodriguez-Correa, Anna Buchner, Gavin C. Harewood, Michael Wallace
- Single-balloon colonoscopy versus repeat standard colonoscopy for previous incomplete colonoscopy: a randomized, controlled trial
- Rajesh N. Keswani
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?