TY - JOUR
T1 - Polypectomy rate is a valid quality measure for colonoscopy
T2 - Results from a national endoscopy database
AU - Williams, Jason E.
AU - Holub, Jennifer L.
AU - Faigel, Douglas O.
PY - 2012/3
Y1 - 2012/3
N2 - Background: The adenoma detection rate (ADR) is one of the main quality measures for colonoscopy, but it is burdensome to calculate and is not amenable to claims-based reporting. Objective: To validate the correlation between polypectomy rates (PRs) and ADRs by using a large group of endoscopists. Design: Retrospective study. Setting: Community and academic endoscopy units in the United States. Subjects: Sixty endoscopists and their patients. Main outcome measurements: Proportion of patients with any adenoma and any polyp removed; correlation between ADRs and PRs. Results: In total, 14,341 screening colonoscopies were included, and there was high correlation between endoscopists' PRs and ADRs in men (rs=.91, P <.0001) and women (rs =.91, P <.0001). Endoscopists with PRs in the highest quartile had a significantly higher ADR than did those in the lowest quartile in men (44.6% vs 19.4%, P <.0001) and women (33.6% vs 11.6%, P <.0001). Endoscopists in the top polypectomy quartile also found more advanced adenomas than did endoscopists in the bottom quartile (men: 9.6% vs 4.6%, P =.0006; women: 6.3% vs 3.0%, P =.01). Benchmark PRs of 40% and 30% correlated with ADRs greater than 25% and 15% for men and women, respectively. Limitation: Retrospective analysis of a subset of a national endoscopic database. Conclusions: Endoscopists' PRs correlate well with their ADRs. Given its clinical relevance, its simplicity, and the ease with which it can be incorporated into claims-based reporting programs, the PR may become an important quality measure.
AB - Background: The adenoma detection rate (ADR) is one of the main quality measures for colonoscopy, but it is burdensome to calculate and is not amenable to claims-based reporting. Objective: To validate the correlation between polypectomy rates (PRs) and ADRs by using a large group of endoscopists. Design: Retrospective study. Setting: Community and academic endoscopy units in the United States. Subjects: Sixty endoscopists and their patients. Main outcome measurements: Proportion of patients with any adenoma and any polyp removed; correlation between ADRs and PRs. Results: In total, 14,341 screening colonoscopies were included, and there was high correlation between endoscopists' PRs and ADRs in men (rs=.91, P <.0001) and women (rs =.91, P <.0001). Endoscopists with PRs in the highest quartile had a significantly higher ADR than did those in the lowest quartile in men (44.6% vs 19.4%, P <.0001) and women (33.6% vs 11.6%, P <.0001). Endoscopists in the top polypectomy quartile also found more advanced adenomas than did endoscopists in the bottom quartile (men: 9.6% vs 4.6%, P =.0006; women: 6.3% vs 3.0%, P =.01). Benchmark PRs of 40% and 30% correlated with ADRs greater than 25% and 15% for men and women, respectively. Limitation: Retrospective analysis of a subset of a national endoscopic database. Conclusions: Endoscopists' PRs correlate well with their ADRs. Given its clinical relevance, its simplicity, and the ease with which it can be incorporated into claims-based reporting programs, the PR may become an important quality measure.
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U2 - 10.1016/j.gie.2011.12.012
DO - 10.1016/j.gie.2011.12.012
M3 - Article
C2 - 22341104
AN - SCOPUS:84863181532
SN - 0016-5107
VL - 75
SP - 576
EP - 582
JO - Gastrointestinal Endoscopy
JF - Gastrointestinal Endoscopy
IS - 3
ER -