Literature DB >> 22540766

Achieving high quality colonoscopy: using graphical representation to measure performance and reset standards.

P T Rajasekhar1, M D Rutter, M G Bramble, D W Wilson, J E East, J R Greenaway, B P Saunders, T J W Lee, R Barton, A P S Hungin, C J Rees.   

Abstract

AIM: Completeness and thoroughness of colonoscopy are measured by the caecal intubation rate (CIR) and the adenoma detection rate (ADR). National standards are ≥ 90% and ≥ 10% respectively. Variability in CIR and ADR have been demonstrated but comparison between individuals and units is difficult. We aimed to assess the performance of colonoscopy in endoscopy units in the northeast of England.
METHOD: Data on colonoscopy performance and sedation use were collected over 3 months from 12 units. Colonoscopies performed by screening colonoscopists were included for the CIR only. Funnel plots with upper and lower 95% confidence limits for CIR and ADR were created.
RESULTS: CIR was 92.5% (n = 5720) and ADR 15.9% (n = 4748). All units and 128 (99.2%) colonoscopists were above the lower limit for CIR. All units achieved the ADR standard with 10 above the upper limit. Ninety-nine (76.7%) colonoscopists were above 10%, 16 (12.4%) above the upper limit and 7 (5.4%) below the lower limit. Median medication doses were 2.2 mg midazolam, 29.4 mg pethidine and 83.3 μg fentanyl. In all, 15.1% of colonoscopies were unsedated. Complications were bleeding (0.10%) and perforation (0.02%). There was one death possibly related to bowel preparation.
CONCLUSION: Results indicate that colonoscopies are performed safely and to a high standard. Funnel plots can highlight variability and areas for improvement. Analyses of ADR presented graphically around the global mean suggest that the national standard should be reset at 15%.
© 2012 The Authors. Colorectal Disease © 2012 The Association of Coloproctology of Great Britain and Ireland.

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Year:  2012        PMID: 22540766     DOI: 10.1111/j.1463-1318.2012.03057.x

Source DB:  PubMed          Journal:  Colorectal Dis        ISSN: 1462-8910            Impact factor:   3.788


  13 in total

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Authors:  Thomas Jw Lee; Keith Siau; Shiran Esmaily; James Docherty; John Stebbing; Matthew J Brookes; Raphael Broughton; Peter Rogers; Paul Dunckley; Matthew D Rutter
Journal:  United European Gastroenterol J       Date:  2019-04-02       Impact factor: 4.623

Review 2.  British society of gastroenterology Endoscopy Quality Improvement Programme (EQIP): overview and progress.

Authors:  Colin J Rees; Sara Koo; John Anderson; Mark McAlindon; Andrew M Veitch; Allan John Morris; Pradeep Bhandari; James E East; George Webster; Kofi W Oppong; Ian D Penman
Journal:  Frontline Gastroenterol       Date:  2019-01-18

3.  The European Society of Gastrointestinal Endoscopy Quality Improvement Initiative: developing performance measures.

Authors:  Matthew D Rutter; Carlo Senore; Raf Bisschops; Dirk Domagk; Roland Valori; Michal F Kaminski; Cristiano Spada; Michael Bretthauer; Cathy Bennett; Cristina Bellisario; Silvia Minozzi; Cesare Hassan; Colin Rees; Mário Dinis-Ribeiro; Tomas Hucl; Thierry Ponchon; Lars Aabakken; Paul Fockens
Journal:  United European Gastroenterol J       Date:  2015-12-17       Impact factor: 4.623

4.  Colonoscopy surveillance following adenoma removal to reduce the risk of colorectal cancer: a retrospective cohort study.

Authors:  Amanda J Cross; Emma C Robbins; Kevin Pack; Iain Stenson; Paula L Kirby; Bhavita Patel; Matthew D Rutter; Andrew M Veitch; Brian P Saunders; Matthew Little; Alastair Gray; Stephen W Duffy; Kate Wooldrage
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5.  The ADENOMA Study. Accuracy of Detection using Endocuff Vision™ Optimization of Mucosal Abnormalities: study protocol for randomized controlled trial.

Authors:  Roisin Bevan; Wee Sing Ngu; Brian P Saunders; Zacharias Tsiamoulos; Paul Bassett; Zoe Hoare; Colin J Rees
Journal:  Endosc Int Open       Date:  2015-11-27

Review 6.  Expert opinions and scientific evidence for colonoscopy key performance indicators.

Authors:  Colin J Rees; Roisin Bevan; Katharina Zimmermann-Fraedrich; Matthew D Rutter; Douglas Rex; Evelien Dekker; Thierry Ponchon; Michael Bretthauer; Jaroslaw Regula; Brian Saunders; Cesare Hassan; Michael J Bourke; Thomas Rösch
Journal:  Gut       Date:  2016-10-08       Impact factor: 23.059

7.  UK key performance indicators and quality assurance standards for colonoscopy.

Authors:  Colin J Rees; Siwan Thomas Gibson; Matt D Rutter; Phil Baragwanath; Rupert Pullan; Mark Feeney; Neil Haslam
Journal:  Gut       Date:  2016-08-16       Impact factor: 23.059

Review 8.  Training in Endoscopy: Colonoscopy.

Authors:  Hyun Joo Jang
Journal:  Clin Endosc       Date:  2017-07-31

9.  Impact of the National Endoscopy Database (NED) on colonoscopy withdrawal time: a tertiary centre experience.

Authors:  Mohamed G Shiha; Ammar Al-Rifaie; Mo Thoufeeq
Journal:  BMJ Open Gastroenterol       Date:  2021-07

10.  Conversion of colonoscopy to flexible sigmoidoscopy: an unintended consequence of quality measurement in endoscopy.

Authors:  Chris Thompson; Tariq Ismail; Simon Radley; Robert Walt; Stephen Thomas Ward
Journal:  Frontline Gastroenterol       Date:  2015-12-11
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