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ASSESSMENT OF COLONOSCOPY QUALITY IN CLINICAL PRACTICE
27 March 2018 (online)
The aim is to assess the quality of colonoscopy in current clinical practice, through the use of online questionnaires, compared with recently published European Society of Gastrointestinal Endoscopy (ESGE) key performance measures.
The development of the online practitioner and procedure questionnaires, by the European Colonoscopy Quality Investigation (ECQI) Group, has been previously described in posters presented at UEGW, 2015 and 2016. Data collection is an ongoing process. We analysed data collected between 2/6/16 and 12/9/17.
64 of 74 practitioners completed the practitioner questionnaire. 3045 colonoscopies were documented by 66 practitioners across 12 European countries. Adequate bowel preparation was defined as Boston Bowel Preparation Scale score ≥6 (ESGE minimum standard ≥90%). From our data (data unavailable for 138, 4.5%), 81.3% (n = 2475) of procedures had adequate bowel cleansing. Caecal intubation rate: ESGE minimum standard of ≥90% of all diagnostic and screening colonoscopies visualise the whole caecum, where indication exists. The caecum was the intended endpoint in 68.9% of procedures (ileum 29.0%, anastomosis 1.3%, data unavailable 0.8%). For those colonoscopies where the caecum was the intended endpoint (n = 2097), 93.2% reached the caecum but only 73.0% stated endpoint photo-documentation. The ESGE recommends that adenoma detection rate (ADR) should be used as a measure of adequate inspection at screening or diagnostic colonoscopy in patients aged ≥50 years. ADR was routinely recorded by only 31.3% of practitioners.
Our findings indicate that some important performance measures recommended by ESGE are not currently being achieved in practice. By providing a self-assessment tool and as a next step, by individual consultations with national Group members, ECQI hopes to improve clinical practice standards.