Polypectomy rate is a valid quality measure for colonoscopy: results from a national endoscopy database - 15/02/12
Reprint requests: Jason E. Williams, MD, Division of Gastroenterology, Santa Clara Valley Medical Center, 751 S. Bascom Ave, San Jose, CA 95128Riassunto |
Background |
The adenoma detection rate (ADR) is one of the main quality measures for colonoscopy, but it is burdensome to calculate and is not amenable to claims-based reporting.
Objective |
To validate the correlation between polypectomy rates (PRs) and ADRs by using a large group of endoscopists.
Design |
Retrospective study.
Setting |
Community and academic endoscopy units in the United States.
Subjects |
Sixty endoscopists and their patients.
Main outcome measurements |
Proportion of patients with any adenoma and any polyp removed; correlation between ADRs and PRs.
Results |
In total, 14,341 screening colonoscopies were included, and there was high correlation between endoscopists' PRs and ADRs in men ( rs= .91, P < .0001) and women (rs = .91, P < .0001). Endoscopists with PRs in the highest quartile had a significantly higher ADR than did those in the lowest quartile in men (44.6% vs 19.4%, P < .0001) and women (33.6% vs 11.6%, P < .0001). Endoscopists in the top polypectomy quartile also found more advanced adenomas than did endoscopists in the bottom quartile (men: 9.6% vs 4.6%, P = .0006; women: 6.3% vs 3.0%, P = .01). Benchmark PRs of 40% and 30% correlated with ADRs greater than 25% and 15% for men and women, respectively.
Limitation |
Retrospective analysis of a subset of a national endoscopic database.
Conclusions |
Endoscopists' PRs correlate well with their ADRs. Given its clinical relevance, its simplicity, and the ease with which it can be incorporated into claims-based reporting programs, the PR may become an important quality measure.
Il testo completo di questo articolo è disponibile in PDF.Abbreviations : ADR, CORI, PR
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| DISCLOSURE: Dr. Faigel was supported in part by an American Society for Gastrointestinal Endoscopy (ASGE) Quality in Endoscopy Research Award and NIDDK U01DK57132. The Clinical Outcomes Research Initiative (CORI) received support from NIDDK U01DK57132 and from the following commercial entities: AstraZeneca, Novartis, Bard International, Pentax USA, ProVation, Endosoft, GIVEN Imaging, and Ethicon. The commercial entities had no involvement in this research. All authors disclosed no financial relationships relevant to this publication. |
Vol 75 - N° 3
P. 576-582 - marzo 2012 Ritorno al numero
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