Regular feedback to individual endoscopists is associated with improved adenoma detection rate and other key performance indicators for colonoscopy.
colonic adenomas
colonic polyps
colorectal cancer
endoscopy
Journal
Frontline gastroenterology
ISSN: 2041-4137
Titre abrégé: Frontline Gastroenterol
Pays: England
ID NLM: 101528589
Informations de publication
Date de publication:
2022
2022
Historique:
received:
05
01
2022
accepted:
11
04
2022
entrez:
17
10
2022
pubmed:
18
10
2022
medline:
18
10
2022
Statut:
epublish
Résumé
Monitoring of key performance indicators (KPIs) is a vital element of endoscopy quality improvement. Adenoma detection rate (ADR) is considered the best marker for colonoscopic quality as it inversely correlates with subsequent colonic cancer incidence and mortality, while polyp detection rate (PDR) is an easier-to-calculate surrogate for ADR. This study assessed whether regular feedback to individual endoscopists about their KPIs improved departmental performance. Individual KPIs were calculated for a period of 8 years (January 2012-December 2019) and fed back to all endoscopists at 6 monthly intervals, alongside anonymised indicators for other endoscopists, aggregate departmental performance data and benchmarks. An automated natural language processing software (EndoMineR) was used to identify adenomas in pathology reports and calculate ADR. Linear regressions were calculated for departmental ADR, PDR and other KPIs at 6 monthly intervals. 39 359 colonoscopies (average 2460 in every 6-month period, range 1799-3059) were performed by an average of 42 (range 34-50) endoscopists. A continuous improvement in collective performance including ADR (12.7%-21.0%, R Regular feedback with individual and departmental KPIs was associated with improved ADR and overall performance throughout the 8-year study period. Concomitant monitoring of ADR and PDR may prevent 'gaming' behaviour and ensure that genuine improvement is achieved.
Identifiants
pubmed: 36250166
doi: 10.1136/flgastro-2022-102091
pii: flgastro-2022-102091
pmc: PMC9555132
doi:
Types de publication
Journal Article
Langues
eng
Pagination
509-516Informations de copyright
© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
Gastrointest Endosc. 2015 Oct;82(4):683-5
pubmed: 26385277
BMJ Open Gastroenterol. 2017 Jun 1;4(1):e000142
pubmed: 28761691
Aliment Pharmacol Ther. 2006 Jul 15;24(2):313-8
pubmed: 16842458
Gut. 2016 Dec;65(12):1923-1929
pubmed: 27531829
Dig Dis Sci. 2017 Apr;62(4):894-902
pubmed: 27995405
Gastrointest Endosc. 2015 Oct;82(4):676-82
pubmed: 26385276
Gastrointest Endosc. 2020 Nov;92(5):1030-1040.e9
pubmed: 32330506
Endosc Int Open. 2017 Jul;5(7):E675-E682
pubmed: 28691053
Am J Gastroenterol. 2013 Feb;108(2):219-26; quiz 227
pubmed: 23295274
Am J Gastroenterol. 2015 Aug;110(8):1134-9
pubmed: 25869388
Gastrointest Endosc. 2010 Jun;71(7):1253-9
pubmed: 20598251
N Engl J Med. 2006 Dec 14;355(24):2533-41
pubmed: 17167136
N Engl J Med. 2014 Apr 3;370(14):1298-306
pubmed: 24693890
Gastroenterology. 2019 May;156(6):1661-1674.e11
pubmed: 30738046
Gastrointest Endosc. 2021 Jan;93(1):77-85.e6
pubmed: 32598963
Frontline Gastroenterol. 2019 Apr;10(2):93-106
pubmed: 31210174
United European Gastroenterol J. 2021 Feb;9(1):120-126
pubmed: 33323062
Gastrointest Endosc. 2015 Jan;81(1):31-53
pubmed: 25480100
Am J Gastroenterol. 2014 Nov;109(11):1714-23; quiz 1724
pubmed: 25135006
J Clin Gastroenterol. 2015 Apr;49(4):313-9
pubmed: 25494362
Best Pract Res Clin Gastroenterol. 2016 Jun;30(3):473-85
pubmed: 27345652
J Gastroenterol Hepatol. 2018 Mar;33(3):645-649
pubmed: 28892839
Surg Endosc. 2021 Jun;35(6):2566-2575
pubmed: 32468263
Gastroenterology. 2011 Jan;140(1):65-72
pubmed: 20854818
Rev Esp Enferm Dig. 2019 Aug;111(8):598-602
pubmed: 31190550
N Engl J Med. 2012 Feb 23;366(8):687-96
pubmed: 22356322
Am J Gastroenterol. 2013 Dec;108(12):1929
pubmed: 24300865
Gastrointest Endosc. 2018 Aug;88(2):209-222.e11
pubmed: 29614263
Cochrane Database Syst Rev. 2012 Jun 13;(6):CD000259
pubmed: 22696318
Gastrointest Endosc. 2013 Jun;77(6):925-31
pubmed: 23472996
N Engl J Med. 2010 May 13;362(19):1795-803
pubmed: 20463339
Endosc Int Open. 2020 Nov;8(11):E1545-E1552
pubmed: 33140009