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ACHIEVEMENT OF EUROPEAN SOCIETY OF GASTROINTESTINAL ENDOSCOPY (ESGE) PERFORMANCE MEASURES: OBSERVATIONS FROM THE EUROPEAN COLONOSCOPY QUALITY INVESTIGATION (ECQI) QUESTIONNAIRE
18 March 2019 (online)
To investigate 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 procedure questionnaire, 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 30/4/18.
6445 colonoscopies were documented by 84 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 209, 3.2%), 84.2% (n = 5427) 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 69.4% of procedures (ileum 28.1%, anastomosis 1.3%, data unavailable 1.2%). For those colonoscopies where the caecum was the intended endpoint (n = 4473), 94.7% reported reaching the caecum but only 77.5% (3281/4234) of those stated endpoint photo-documentation.
Polyp detection rate (PDR) (ESGE minimum standard ≥40% of screening and diagnostic colonoscopies performed in those aged 50 years or older). At least one polyp was detected in 40.7% (1357/3335) of qualifying procedures.
Withdrawal time from caecum to anal canal and inspection of the entire bowel mucosa at negative (no biopsy or therapy) screening or diagnostic colonoscopy (ESGE minimum standard mean 6 minutes). Of the 1150 qualifying procedures providing data, the overall mean (± SD) withdrawal time was 7.8 ± 3.1 minutes, the median withdrawal time was 7 minutes.
Our findings indicate that while minimum standards for PDR and withdrawal time are being met, they are not achieved for adequate bowel clearance, or photo-documentation of caecal intubation.