INTRODUCTION: To determine whether the annual case volume of general surgeons (greater or less than 200 colonoscopies) is associated with quality outcomes. METHODS: This retrospective cohort study involved all adults who underwent colonoscopy by a surgeon in the city of St. John's, NL, during the first 6 months of 2012. Subjects were identified through records from the health authority, and data were recorded on a standardized data sheet. Univariate analysis followed by stepwise multivariable logistic regression was performed to determine whether there was an association between quality outcomes (colonoscopy completion rate, adenoma detection rate) and predictors of these outcomes including annual colonoscopy volume, patient age, gender, indication for colonoscopy, and ASA score. A Chi-squared test was used to determine whether other outcomes were associated with annual colonoscopy volume. RESULTS: Data were collected on 1060 patients. Mean age was 59.5 (sd 12.2) years with 550 females. A total of 13 surgeons were studied, of which 7 performed less than 200 annual colonoscopies over the previous 2 years (low-volume group) and 6 performed more than 200 annual colonoscopies over the previous 2 years (high-volume group). While there was a significant difference in the colonoscopy completion rate favoring the high-volume group (82.2 vs. 91.1 %, p < 0.001), no difference was noted in the adenoma detection rate between groups (16.7 vs. 17.7 %, p = 0.762). The regression model revealed that colonoscopy completion was also associated with an indication of screening or surveillance and an ASA score of 1 or 2. The adenoma detection rate was associated with older age and male gender. There was no statistically significant association between annual colonoscopy volume and other safety outcome measures. CONCLUSION: Performing over 200 colonoscopies annually is associated with higher colonoscopy completion rates, but does not appear to be associated with other quality measures.
INTRODUCTION: To determine whether the annual case volume of general surgeons (greater or less than 200 colonoscopies) is associated with quality outcomes. METHODS: This retrospective cohort study involved all adults who underwent colonoscopy by a surgeon in the city of St. John's, NL, during the first 6 months of 2012. Subjects were identified through records from the health authority, and data were recorded on a standardized data sheet. Univariate analysis followed by stepwise multivariable logistic regression was performed to determine whether there was an association between quality outcomes (colonoscopy completion rate, adenoma detection rate) and predictors of these outcomes including annual colonoscopy volume, patient age, gender, indication for colonoscopy, and ASA score. A Chi-squared test was used to determine whether other outcomes were associated with annual colonoscopy volume. RESULTS: Data were collected on 1060 patients. Mean age was 59.5 (sd 12.2) years with 550 females. A total of 13 surgeons were studied, of which 7 performed less than 200 annual colonoscopies over the previous 2 years (low-volume group) and 6 performed more than 200 annual colonoscopies over the previous 2 years (high-volume group). While there was a significant difference in the colonoscopy completion rate favoring the high-volume group (82.2 vs. 91.1 %, p < 0.001), no difference was noted in the adenoma detection rate between groups (16.7 vs. 17.7 %, p = 0.762). The regression model revealed that colonoscopy completion was also associated with an indication of screening or surveillance and an ASA score of 1 or 2. The adenoma detection rate was associated with older age and male gender. There was no statistically significant association between annual colonoscopy volume and other safety outcome measures. CONCLUSION: Performing over 200 colonoscopies annually is associated with higher colonoscopy completion rates, but does not appear to be associated with other quality measures.
Authors: V Moritz; M Bretthauer; H K Ruud; T Glomsaker; T de Lange; P Sandvei; G Huppertz-Hauss; Ø Kjellevold; G Hoff Journal: Endoscopy Date: 2012-04-24 Impact factor: 10.093
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Authors: Douglas J Robertson; E Robert Greenberg; Michael Beach; Robert S Sandler; Dennis Ahnen; Robert W Haile; Carol A Burke; Dale C Snover; Robert S Bresalier; Gail McKeown-Eyssen; Jack S Mandel; John H Bond; Rosalind U Van Stolk; Robert W Summers; Richard Rothstein; Timothy R Church; Bernard F Cole; Tim Byers; Leila Mott; John A Baron Journal: Gastroenterology Date: 2005-07 Impact factor: 22.682
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Authors: Hemant A Shah; Lawrence F Paszat; Refik Saskin; Therese A Stukel; Linda Rabeneck Journal: Gastroenterology Date: 2007-03-21 Impact factor: 22.682
Authors: Thomas J W Lee; Colin J Rees; Roger G Blanks; Sue M Moss; Claire Nickerson; Karen C Wright; Peter W James; Richard J Q McNally; Julietta Patnick; Matthew D Rutter Journal: Endoscopy Date: 2014-01-28 Impact factor: 10.093
Authors: S J Winawer; A G Zauber; M N Ho; M J O'Brien; L S Gottlieb; S S Sternberg; J D Waye; M Schapiro; J H Bond; J F Panish Journal: N Engl J Med Date: 1993-12-30 Impact factor: 91.245
Authors: Jan M Eberth; Whitney E Zahnd; Michele J Josey; Mario Schootman; Peiyin Hung; Janice C Probst Journal: Spat Spatiotemporal Epidemiol Date: 2021-03-06
Authors: Nancy E Aguilar-Olivos; Ricardo Balanzá; Fernando Rojas-Mendoza; Rodrigo Soto-Solis; Mario A Ballesteros-Amozurrutia; Norma González-Uribe; Justo A Fernández-Rivero Journal: Endosc Int Open Date: 2021-05-27