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Effect of quality metric monitoring and colonoscopy performance
Background and aims: Adenoma detection rate (ADR) and cecal withdrawal time (CWT) have been identified as measures of colonoscopy quality. This study evaluates the impact of monitoring these measures on provider performance. Methods: Six blinded gastroenterologists practicing at a Veterans Affairs M...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
© Georg Thieme Verlag KG
2016
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5063644/ https://www.ncbi.nlm.nih.gov/pubmed/27747273 http://dx.doi.org/10.1055/s-0042-110787 |
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author | Razzak, Anthony Smith, Dineen Zahid, Maliha Papachristou, Georgios Khalid, Asif |
author_facet | Razzak, Anthony Smith, Dineen Zahid, Maliha Papachristou, Georgios Khalid, Asif |
author_sort | Razzak, Anthony |
collection | PubMed |
description | Background and aims: Adenoma detection rate (ADR) and cecal withdrawal time (CWT) have been identified as measures of colonoscopy quality. This study evaluates the impact of monitoring these measures on provider performance. Methods: Six blinded gastroenterologists practicing at a Veterans Affairs Medical Center were prospectively monitored over 9 months. Data for screening, adenoma surveillance, and fecal occult blood test positive (FOBT +) indicated colonoscopies were obtained, including exam preparation quality, cecal intubation rate, CWT, ADR, adenomas per colonoscopy (APC), and adverse events. Metrics were continuously monitored after a period of informed CWT monitoring and informed CWT + ADR monitoring. The primary outcome was impact on ADR and APC. Results: A total of 1671 colonoscopies were performed during the study period with 540 before informed monitoring, 528 during informed CWT monitoring, and 603 during informed CWT + ADR monitoring. No statistically significant impact on ADR was noted across each study phase. Multivariate regression revealed a trend towards fewer adenomas removed during the CWT monitoring phase (OR = 0.79; 95 %CI 0.62 – 1.02, P = 0.065) and a trend towards more adenomas removed during the CWT + ADR monitoring phase when compared to baseline (OR = 1.26; 95 %CI 0.99 – 1.61, P = 0.062). Indication for examination and provider were significant predictors for higher APC. Provider-specific data demonstrated a direct relationship between high ADR performers and increased CWT. Conclusions: Monitoring quality metrics did not significantly alter colonoscopy performance across a small heterogeneous group of providers. Non-significant trends towards higher APC were noted with CWT + ADR monitoring. Providers with a longer CWT had a higher ADR. Further studies are needed to determine the impact of monitoring on colonoscopy performance. |
format | Online Article Text |
id | pubmed-5063644 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | © Georg Thieme Verlag KG |
record_format | MEDLINE/PubMed |
spelling | pubmed-50636442016-10-14 Effect of quality metric monitoring and colonoscopy performance Razzak, Anthony Smith, Dineen Zahid, Maliha Papachristou, Georgios Khalid, Asif Endosc Int Open Background and aims: Adenoma detection rate (ADR) and cecal withdrawal time (CWT) have been identified as measures of colonoscopy quality. This study evaluates the impact of monitoring these measures on provider performance. Methods: Six blinded gastroenterologists practicing at a Veterans Affairs Medical Center were prospectively monitored over 9 months. Data for screening, adenoma surveillance, and fecal occult blood test positive (FOBT +) indicated colonoscopies were obtained, including exam preparation quality, cecal intubation rate, CWT, ADR, adenomas per colonoscopy (APC), and adverse events. Metrics were continuously monitored after a period of informed CWT monitoring and informed CWT + ADR monitoring. The primary outcome was impact on ADR and APC. Results: A total of 1671 colonoscopies were performed during the study period with 540 before informed monitoring, 528 during informed CWT monitoring, and 603 during informed CWT + ADR monitoring. No statistically significant impact on ADR was noted across each study phase. Multivariate regression revealed a trend towards fewer adenomas removed during the CWT monitoring phase (OR = 0.79; 95 %CI 0.62 – 1.02, P = 0.065) and a trend towards more adenomas removed during the CWT + ADR monitoring phase when compared to baseline (OR = 1.26; 95 %CI 0.99 – 1.61, P = 0.062). Indication for examination and provider were significant predictors for higher APC. Provider-specific data demonstrated a direct relationship between high ADR performers and increased CWT. Conclusions: Monitoring quality metrics did not significantly alter colonoscopy performance across a small heterogeneous group of providers. Non-significant trends towards higher APC were noted with CWT + ADR monitoring. Providers with a longer CWT had a higher ADR. Further studies are needed to determine the impact of monitoring on colonoscopy performance. © Georg Thieme Verlag KG 2016-10 2016-08-05 /pmc/articles/PMC5063644/ /pubmed/27747273 http://dx.doi.org/10.1055/s-0042-110787 Text en © Thieme Medical Publishers |
spellingShingle | Razzak, Anthony Smith, Dineen Zahid, Maliha Papachristou, Georgios Khalid, Asif Effect of quality metric monitoring and colonoscopy performance |
title | Effect of quality metric monitoring and colonoscopy performance |
title_full | Effect of quality metric monitoring and colonoscopy performance |
title_fullStr | Effect of quality metric monitoring and colonoscopy performance |
title_full_unstemmed | Effect of quality metric monitoring and colonoscopy performance |
title_short | Effect of quality metric monitoring and colonoscopy performance |
title_sort | effect of quality metric monitoring and colonoscopy performance |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5063644/ https://www.ncbi.nlm.nih.gov/pubmed/27747273 http://dx.doi.org/10.1055/s-0042-110787 |
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