Open AccessTime trends in quality indicators of colonoscopy
Author(s) -
Moritz Volker,
Bretthauer Michael,
Holme Øyvind,
Wang Fagerland Morten,
Løberg Magnus,
Glomsaker Tom,
Lange Thomas,
Seip Birgitte,
Sandvei Per,
Hoff Geir
Publication year - 2016
Publication title -
ueg journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.667
H-Index - 35
eISSN - 2050-6414
pISSN - 2050-6406
DOI - 10.1177/2050640615570147
Subject(s) - medicine , colonoscopy , intubation , sedation , endoscopy , prospective cohort study , multivariate analysis , bowel preparation , logistic regression , norwegian , general surgery , emergency medicine , surgery , colorectal cancer , linguistics , philosophy , cancer
Background There is considerable variation in the quality of colonoscopy performance. The Norwegian quality assurance programme Gastronet registers outpatient colonoscopies performed in Norwegian endoscopy centres. The aim of Gastronet is long‐term improvement of endoscopist and centre performance by annual feedback of performance data. Objective The objective of this article is to perform an analysis of trends of quality indicators for colonoscopy in Gastronet. Methods This prospective cohort study included 73,522 outpatient colonoscopies from 73 endoscopists at 25 endoscopy centres from 2003 to 2012. We used multivariate logistic regression with adjustment for relevant variables to determine annual trends of three performance indicators: caecum intubation rate, pain during the procedure, and detection rate of polyps ≥5 mm. Results The proportion of severely painful colonoscopies decreased from 14.8% to 9.2% (relative risk reduction of 38%; OR = 0.92 per year in Gastronet; 95% CI 0.86–1.00; p = 0.045). Caecal intubation (OR = 0.99; 95% CI 0.94–1.04; p = 0.6) and polyp detection (OR = 1.03; 95% CI 0.99–1.07; p = 0.15) remained unchanged during the study period. Conclusions Pain at colonoscopy showed a significant decrease during years of Gastronet participation while caecal intubation and polyp detection remained unchanged – independent of the use of sedation and/or analgesics and level of endoscopist experience. This may be due to the Gastronet audit, but effects of improved endoscopy technology cannot be excluded.