Long-Term Follow Up of Colonoscopy Quality Monitoring

• Published in: Clinical and translational gastroenterology Vol. 14; no. 9; p. e00608
• Main Authors: Patel, Feenalie, Dilly, Christen, Fayad, Nabil, Marri, Smitha, Eckert, George J, Kahi, Charles
• Format: Journal Article
• Language: English
• Published: United States Wolters Kluwer 01.09.2023
• Subjects: Colon
• ISSN: 2155-384X; 2155-384X
• DOI: 10.14309/ctg.0000000000000608

High-quality colonoscopy is paramount for colorectal cancer prevention. Since 2009, endoscopists at our institution have received quarterly report cards summarizing individual colonoscopy quality indicators. We have previously shown that implementing this intervention was associated with short-term improvement in adenoma detection rate (ADR). However, the long-term effect of continued monitoring on colonoscopy quality is unclear. We conducted a retrospective study of prospectively administered quarterly colonoscopy quality report cards at the Roudebush VA Medical Center between April 1, 2012 and August 31, 2019. The anonymized reports included individual endoscopists' ADRs, cecal intubation rates, and withdrawal times. Analyses were performed to determine slopes over time for each quality metric by physician and assess for differences based on whether ADRs were calculated quarterly or yearly. Data from the report cards of 17 endoscopists who had performed 24,361 colonoscopies were included. The mean quarterly ADR (±SD) was 51.7% (±11.7%) and mean yearly ADR was 47.2% (±13.8%). There was a small increase in overall ADR based on quarterly and yearly measurements (slope + 0.6%, p=0.02; and slope +2.7%, p < 0.001, respectively), but no significant change in individual ADRs, cecal intubation rates, or withdrawal times. Analysis of standard deviation of ADRs showed no significant difference between yearly and quarterly measurements (p=0.064). Individual endoscopists' ADR standard deviation differences between yearly and quarterly measurement ranged from -4.7% to +6.8%. Long-term colonoscopy quality monitoring paralleled stable improvements in overall ADR. For endoscopists with baseline high ADR, frequent monitoring and reporting of colonoscopy quality metrics may not be necessary.