Background and Aims
There has been a tremendous increase in research focused on quality metrics in colonoscopy
since 2000. However, whether national performance in colonoscopy quality outcomes
has changed significantly since then is not as well known.
Methods
We examined colonoscopy data collected prospectively through the Clinical Outcomes
Research Initiative, which included 84 GI practice sites from 2000 to 2014 for patients
undergoing colonoscopy for multiple indications. Colonoscopy outcomes by indication
were compared across three 5-year periods (2000-2004, 2005-2009, 2010-2014) using
the following metrics: bowel preparation quality (percentage good/excellent), finding
a polyp, finding 2 or more polyps, and finding a polyp >9 mm. Multivariate logistic
regression was used to generate odds ratios and 95% confidence intervals for each
time period while controlling for age, gender, and race/ethnicity.
Results
A total of 1,541,837 adults were included in the study across all indication groups.
The average-risk screening group (390,741 adults) demonstrated statistically significant
improvement across all 4 quality metrics when comparing the baseline period with the
final time period. Bowel preparation quality improved across all indications when
comparing the baseline period with the final time period. Finding a polyp, finding
2 or more polyps, and finding a polyp >9 mm improved in the average-risk screening,
surveillance, and diagnostic indication groups when comparing the baseline period
with the final time period. The increased-risk screening and inflammatory bowel disease
indication groups did not see improvements beyond bowel preparation quality when comparing
the baseline with the final time period.
Conclusion
Colonoscopy outcomes as measured by bowel preparation quality, finding a polyp, finding
2 or more polyps, and finding a polyp >9 mm improved significantly over the 15-year
period between 2000 and 2014, with the largest and most consistent impact in the average-risk
screening indication group.
Abbreviations:
ACG (American College of Gastroenterology), ADR (adenoma detection rate), AGA (American Gastroenterologic Association), ASA (American Society of Anesthesiologists), ASGE (American Society for Gastrointestinal Endoscopy)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: June 14, 2019
Footnotes
DISCLOSURE: All authors disclosed no financial relationships relevant to this publication.
Identification
Copyright
© 2019 by the American Society for Gastrointestinal Endoscopy
