The Clinical Outcomes Research Initiative (CORI) was developed to create a physician network to capture endoscopy data from a wide spectrum of GI specialists. The primary goals of the first phase of the project are to determine why clinicians are performing endoscopy, and examine the relationship between indications for endoscopy and endoscopic findings. The purpose of this preliminary study is to demonstrate the merger of data from multiple sites to identify practice variation. Methods: A computerized endoscopy report generator was developed during one year of field testing at 5 sites. Endoscopy data is extracted from the report, and sent electronically to a central data bank and pooled with data from multiple sites for analysis. For this preliminary report, data was collected over 4 weeks from 6 sites located in Oregon, North Dakota, Nebraska and Wash.D.C.. Sites included University group practices (3), VA (1), rural practice group (1) and an urban practice group (1). Analysis was performed to determine the rate of esophageal pathology, defined as esophagitis or Barrett's esophagus (BE) in patients undergoing endoscopy (EGD) because of symptoms of gastroesophageal reflux (GER-Sx). Results: 402 consecutive patients were included. GER-Sx was the most common reason for performing EGD (22% of procedures). Significant differences m the rate of BE were discovered in patients undergoing EGD for GER-Sx in various practice settings: Indication EGD Result Site for EGD: % of pts with GER Sx who have: # % with GER-Sx Suspected BE Esophagitis Either 1 19 5 20 22 2 19 0 13 13 3 21 5 11 15 4 26 7 18 22 5 21 14* 21 36 6 20 *p<0.01 18* 14 28 Conclusions: A computerized endoscopy report generator can be used to capture endoscopic data from diverse practice settings. This snapshot of endoscopic practice can identify practice patterns and variation, evaluate patient outcomes, and stimulate hypotheses regarding practice differences. The CORI database will be a resource for clinical outcomes studies in endoscopy. During the next year, 50 new sites will be added to the database.
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging