OC-047 Correlation of Caecal Intubation Rate to Volume – Colonoscopists should Undertake at least 120 Procedures per Year

Abstract

<h3>Introduction</h3> Quality assurance of colonoscopy is a central theme in endoscopic provision. In the UK the Joint Advisory Group on Gastrointestinal endoscopy (JAG), has issued guidance for caecal intubation rates (CIR) of 90% or higher on an intention-to-colonoscope basis. They also advise that practitioners should undertake at least 100 colonoscopies per annum. We looked at the correlation between volume per annum and CIR to test JAG’s standard. <h3>Methods</h3> We analysed 129 operator records who undertook between 20–399 colonoscopies per annum. This amounted to 12 594 colonoscopies undertaken over a two year period (2008–9) across 6 hospitals in 3 regions. Each operator’s volume per annum was plotted against CIR. This was done as individual operators and also when individuals were grouped with others performing a similar volume of colonoscopy per annum (groups of 50). An additional analysis of operators undertaking 20–199 colonoscopies per annum looked at groups of 20 and groups of 10. <h3>Results</h3> Figure A shows a scatter plot of individuals’ volume (per annum) against CIR, the trend-line crosses the 90% CIR standard at 125 procedures per annum. The 3 other scatter plots of individuals grouped with others undertaking a similar volume per annum (groups of 50, 20 and 10) plotted against CIR, the trend-line crosses the 90% CIR standard at 110–120 procedures per annum. <h3>Conclusion</h3> The analysis of 12 594 colonoscopies, performed by 129 operators, carrying out between 20–399 colonoscopies per annum, suggest that to meet a minimum CIR standard of 90% at least 120 colonoscopies should be performed per annum. This is equivalent to performing 3 colonoscopies per week. We recommend advisory bodies on quality standards adopt this minimum activity threshold into their guidance. <h3>Disclosure of Interest</h3> None Declared