Public Reporting of Colonoscopy Quality is Associated with an Increase in Endoscopist Adenoma Detection Rate

Overview

Journal Gastrointest Endosc

Specialties Gastroenterology
Pharmacology
Radiology

Date 2015 Sep 20

PMID 26385276

Citations 19

Authors

Heitham Abdul-Baki

Robert E Schoen

Katie Dean

Sherri Rose

Daniel A Leffler

Eliathamby Kuganeswaran

Michele Morris

David Carrell

Ateev Mehrotra

Affiliations

Soon will be listed here.

Abstract

Background: Colonoscopy is the predominant method for colorectal cancer screening in the United States. Previous studies have documented variation across physicians in colonoscopy quality as measured by the adenoma detection rate (ADR). ADR is the primary quality measure of colonoscopy examinations and an indicator of the likelihood of subsequent colorectal cancer. There is interest in mechanisms to improve the ADR. In Central Illinois, a local employer and a quality improvement organization partnered to publically report physician colonoscopy quality.

Objective: We assessed whether this initiative was associated with an improvement in the ADR.

Design: We compared ADRs before and after public reporting at a private practice endoscopy center with 11 gastroenterologists in Peoria, Illinois, who participated in the initiative. To generate the ADR, colonoscopy and pathology reports from examinations performed over 4 years at the endoscopy center were analyzed by using previously validated natural language processing software.

Setting: A central Illinois endoscopy center.

Results: The ADR in the pre-public reporting period was 34.3% and 39.2% in the post-public reporting period (an increase of 4.9%, P < .001). The increase in the right-sided ADR was 5.1% (P < .01), whereas the increase in the left-sided ADR was 2.1% (P < .05). The increase in the ADR was 7.8% for screening colonoscopies (P < 0.05) and 3.5% for nonscreening colonoscopies (P < .05). All but 1 physician's ADR increased (range -2.7% to 10.5%). There was no statistically significant change in the advanced ADR (increase of 0.8%, P = .22).

Limitations: There was no concurrent control group to assess whether the increased ADR was due to a secular trend.

Conclusion: A public reporting initiative on colonoscopy quality was associated with an increase in ADR.

Citing Articles

Colonoscopy Remains an Important Option for Primary Screening for Colorectal Cancer.

Rex D Dig Dis Sci. 2024; .

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Regular feedback to individual endoscopists is associated with improved adenoma detection rate and other key performance indicators for colonoscopy.

Lim S, Tritto G, Zeki S, Demartino S Frontline Gastroenterol. 2022; 13(6):509-516.

PMID: 36250166 PMC: 9555132. DOI: 10.1136/flgastro-2022-102091.

Natural Language Processing for Assessing Quality Indicators in Free-Text Colonoscopy and Pathology Reports: Development and Usability Study.

Bae J, Han H, Yang S, Song G, Sa S, Chung G JMIR Med Inform. 2022; 10(4):e35257.

PMID: 35436226 PMC: 9055472. DOI: 10.2196/35257.

Impact of feedback on adenoma detection rate: a systematic review and meta-analysis.

Boregowda U, Desai M, Nutalapati V, Paleti S, Olyaee M, Rastogi A Ann Gastroenterol. 2021; 34(2):214-223.

PMID: 33654362 PMC: 7903562. DOI: 10.20524/aog.2021.0591.

Evolving Role and Future Directions of Natural Language Processing in Gastroenterology.

Nehme F, Feldman K Dig Dis Sci. 2020; 66(1):29-40.

PMID: 32107677 DOI: 10.1007/s10620-020-06156-y.

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