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Variation in Colonoscopy Performance Measures According to Procedure Indication

2019; Elsevier BV; Volume: 18; Issue: 5 Linguagem: Inglês

10.1016/j.cgh.2019.08.035

1542-7714

Carolina Mangas‐Sanjuán, Enrique Santana, Joaquín Cubiella, Elena Rodríguez‐Camacho, Agustín Seoane, Marco Antonio Álvarez, Adolfo Suárez, Verónica Álvarez‐García, Natalia González, Alberto Lué, Lucia Amelia Cid-Gómez, Marta Ponce, Luís Bujanda, Isabel Portillo, María Pellisé, Pilar Díez‐Redondo, Maite Herráiz, Akiko Ono, Ángeles Pizarro, Pedro Zapater, Rodrigo Jover, Rodrigo Jover, Carolina Mangas‐Sanjuán, Enrique Santana, Juan Antonio Casellas, Francisco Antonio Ruiz-Gómez, Eva Serrano, Cristina Mira, Adolfo Suárez, Verónica Álvarez‐García, Olegario Castaño, Lorena Blanco, Natalia González, Javier Lara, Enrique Quintero, Headache Clinic, María Pellisé, Liseth Rivero, Josep Llach, Henry Córdova, Isis K. Araujo, Ariadna Sánchez, Íngrid Ordás, Karina Lisette, H. del Mar, Agustín Seoane, Marco Antonio Álvarez, Laura Carot, Inés Ibáñez, Faust Riu, Miguel Pantaleón Sánchez, Josep Maria Dedéu, Luis E. Barranco, Akiko Ono, Joaquín Cubiella, Elena Rodríguez‐Camacho, Franco Baiocchi, Coral Tejido Sandoval, Luís Bujanda, Isabel Portillo, Isabel Idígoras, Isabel Bilbao, Maite Herráiz, Cristina Carretero, Maite Betés, Ángeles Pizarro, Marta Ponce, Marco Bustamante, Vicente Pons, Lídia Argüello, Carla Satorres, Pilar Díez‐Redondo, Henar Núñez, Victoria Busto, Lucía Cid-Gómez, Vicent Hernández, Luisa de Castro, Nereida Fernández-Fernández, Alfonso Martínez-Turnes, Beatriz Romero-Mosquera, Romina Fernández-Poceiro, Alberto Lué, Ángel Lanas, Ángel Ferrández, Pilar Roncales,

Colorectal Cancer Surgical Treatments

Background & Aims Most fulfillment and benchmarking information for colonoscopy quality indicators has been obtained from studies of primary screening colonoscopies. We analyzed differences in the fulfillment of colonoscopy quality indicators based on the indication for endoscopy. Methods We performed an observational, multicenter, cross-sectional study of 14,867 patients who underwent endoscopy procedures for gastrointestinal symptoms (40.3%), a positive result from a fecal immunochemical test (36.0%), postpolypectomy surveillance (15.3%), or primary screening (8.4%), from February 2016 through December 2017 at 14 centers in Spain. We evaluated rates of adequate colon cleansing, cecal intubation, adenoma detection, and colorectal cancer detection, among others. We used findings from primary screening colonoscopies as the reference standard. Results Fewer than 90% of patients had adequate bowel preparation; 83.1% of patients with gastrointestinal symptoms had adequate bowel preparation (odds ratio [OR] compared with patients with primary screening colonoscopies, 0.62; 95% CI, 0.49–0.78) and 85.3% of patients receiving postpolypectomy surveillance had adequate bowel preparation (OR, 0.71; 95% CI, 0.55–0.91). The cecal intubation rate was also lower in patients with gastrointestinal symptoms (93.1%) (OR, 0.34; 95% CI, 0.22–0.52). The adenoma detection rate was higher in patients with a positive result from a fecal immunochemical test (46.4%) (OR, 2.01; 95% CI, 1.71–2.35) and in patients undergoing postpolypectomy surveillance (48.2%) (OR, 1.41; 95% CI, 1.20–1.67). The highest proportion of patients with colorectal cancer was in the gastrointestinal symptom group (5.1%) (OR, 5.24; 95% CI, 2.30–11.93) and the lowest was in patients undergoing surveillance (0.8%) (OR, 0.83; 95% CI, 0.32–2.14). Conclusions Fulfillment of colonoscopy performance measures varies substantially by indication. Policies addressing performance measures beyond colonoscopy screening procedures should be developed. Benchmarking recommendations could be adjusted according to colonoscopy indication.