Abstract

Introduction Since 2011, our institution has distributed annual reports, in June, to providers with personalized data regarding adenoma detection rate (ADR), colonoscope withdrawal time (CW), and cecal intubation (CI) rate, using standardized reporting systems. We examined the impact of distribution of individualized reports at the midpoint of each year on colonoscopy outcomes in the latter half of each year. Methods Providers with endoscopy privileges, performing ≥20 colonoscopies/year, at our center throughout a five-year period (2011-2015) were included. The three metrics recorded and reported were ADR, CW, and CI using standard benchmark rates. The mean values of each metric from January through June (1st half) and July through December (2nd half) were calculated. Curve estimation test was used to determine the significance of ADR in the respective time period. Results Fifteen providers were eligible for the study. Collective ADR in the 1st half of all years was 26.9% and in the second half of all years was 28.1% (p = 0.476). CW for all years was more than 9 minutes while CI was above 90% for all providers. There was no significant increase in the CI and CW during the 5-year study period. Overall, ADR increased from 26.43% (2011) to 33.47% (2015) (p = 0.137). When examining ADR during each of the 12 months following the June report cards, there was no month-to-month trend observed (p = 0.893). Conclusion Endoscopists at our institutions met/exceeded the quality metrics in the first half of each year from the beginning of the study. Routine reporting may maintain, but not improve, outcomes. Long-term studies to determine if periodic feedback to endoscopists improves the quality of endoscopy as per national standards for detection of early colorectal cancers are required.

Highlights

  • Since 2011, our institution has distributed annual reports, in June, to providers with personalized data regarding adenoma detection rate (ADR), colonoscope withdrawal time (CW), and cecal intubation (CI) rate, using standardized reporting systems

  • Based on the inclusion criteria, 15 providers who performed more than 20 colonoscopies per year in all 5 years were eligible for the study

  • The ADR decreased in the 2nd half of 2012 (26.1% to 22.9%) and 2013 (26.7% to 25.2%) as compared to the first half whereas it increased in the remaining years

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Summary

Introduction

Since 2011, our institution has distributed annual reports, in June, to providers with personalized data regarding adenoma detection rate (ADR), colonoscope withdrawal time (CW), and cecal intubation (CI) rate, using standardized reporting systems. Endoscopists at our institutions met/exceeded the quality metrics in the first half of each year from the beginning of the study. Long-term studies to determine if periodic feedback to endoscopists improves the quality of endoscopy as per national standards for detection of early colorectal cancers are required. Colonoscopy is widely used in the diagnosis and treatment of colon disorders It has a primary role in the detection and prevention of colorectal cancer (CRC), the third leading cause of cancer death in the United States [1]. The ability to reduce the incidence of colorectal cancer using colonoscopy is dependent on the removal of adenomas and depends on the operator [6]. Suboptimal performance of colonoscopy by some endoscopists, as evidenced by variable performance, is an obstacle to colonoscopy’s ability to provide protection against incident colorectal cancers [7]. Concerned about the miss rate, despite being low, for cancers and adenomatous polyps, high-quality examination was suggested to ensure the detection and removal of all neoplastic lesions [8, 9]

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