Nederlands tijdschrift voor geneeskunde · 2012
[Quality indicators for colonoscopy: differences in polyp detection between endoscopists at one hospital].
Сравнительное исследованиеАннотация на английскомСтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
van Lelyveld Niels, van Oijen Martijn G H, Schwartz Matthijs P
Аннотация
OBJECTIVE: To compare quality indicators for colonoscopy between different endoscopists at a large community hospital in order to assess the quality of care and the need for structural implementation of quality measurement.
DESIGN: Retrospective, descriptive.
METHOD: Data were analysed from all colonoscopies performed by 5 experienced endoscopists (4 gastroenterologists, 1 internist) during the period November 2008-April 2009. For each endoscopist, the percentage of colonoscopies in which the caecum was intubated was established and the adenoma detection rate (ADR) scored. The ADR is the percentage of colonoscopies in which at least 1 adenomatous polyp is found. A comparison between endoscopists was performed thereafter.
RESULTS: A total of 1006 colonoscopies had been performed of which 700 were included. Mean patient age was 61 years (SD: 16). The caecal intubation rate ranged between 88-97% and was statistically significantly different between the endoscopists (p = 0.045). The ADR for all polyps also differed significantly between endoscopists (p < 0.01). Similar differences were found when only large polyps (> 15 mm) were counted. An age of more than 50 years and caecal intubation were independently associated with a greater chance of polyp detection, with odds ratios of 4.3 (95%-CI: 2.8-6.8) and 2.6 (95%-CI: 1.5-4.6), respectively.
CONCLUSION: Great variation in quality indicators for colonoscopy was found between endoscopists at a large community hospital. The outcome of this study stresses the need for structural implementation of transparent and measurable quality indicators for colonoscopy.
DESIGN: Retrospective, descriptive.
METHOD: Data were analysed from all colonoscopies performed by 5 experienced endoscopists (4 gastroenterologists, 1 internist) during the period November 2008-April 2009. For each endoscopist, the percentage of colonoscopies in which the caecum was intubated was established and the adenoma detection rate (ADR) scored. The ADR is the percentage of colonoscopies in which at least 1 adenomatous polyp is found. A comparison between endoscopists was performed thereafter.
RESULTS: A total of 1006 colonoscopies had been performed of which 700 were included. Mean patient age was 61 years (SD: 16). The caecal intubation rate ranged between 88-97% and was statistically significantly different between the endoscopists (p = 0.045). The ADR for all polyps also differed significantly between endoscopists (p < 0.01). Similar differences were found when only large polyps (> 15 mm) were counted. An age of more than 50 years and caecal intubation were independently associated with a greater chance of polyp detection, with odds ratios of 4.3 (95%-CI: 2.8-6.8) and 2.6 (95%-CI: 1.5-4.6), respectively.
CONCLUSION: Great variation in quality indicators for colonoscopy was found between endoscopists at a large community hospital. The outcome of this study stresses the need for structural implementation of transparent and measurable quality indicators for colonoscopy.