Literature DB >> 20970795

Polypectomy rate as a quality measure for colonoscopy.

Jason E Williams1, Thienluong Domi Le, Douglas O Faigel.   

Abstract

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 (r(s) = 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.
Copyright © 2011. Published by Mosby, Inc.

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Mesh:

Year:  2011        PMID: 20970795     DOI: 10.1016/j.gie.2010.08.008

Source DB:  PubMed          Journal:  Gastrointest Endosc        ISSN: 0016-5107            Impact factor:   9.427


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