colonoscopy performance between endoscopy services. Methods: Prospectively collected data recorded in the Dutch Gastrointestinal Endoscopy Audit (DGEA) between 01-01-2016 and 31-12-2019 were analyzed. The DGEA is the national colonoscopy registry of endoscopy services in the Netherlands. Academic, non-academic and private endoscopy services are participating in the DGEA. Performance on cecal intubation rate (CIR) and rate of adequate bowel preparation (ABPR) were studied in the total study population per endoscopy service. The polyp detection rate (PDR) was studied in fecal immunochemical test (FIT)-positive screening colonoscopies. Variation in case-mix factors (age, sex, ASA score and indication) between endoscopy services was assessed. Expected outcomes for the CIR, ABPR and PDR were calculated, based on the case-mix factors of all patients per endoscopy service, using a multivariable logistic regression model. Results: During the 4-year study period, 363,840 colonoscopies were recorded from 51 endoscopy services in the DGEA. Significant differences in the mean percentage per endoscopy service were observed for several case-mix factors; age higher than 65 years (range (r): 33.4 -53.6%, p < 0.001), male patients (r: 46.2 -58.2%, p < 0.001), ASA 3 or higher (r: 0.2 -24.9%, p < 0.001) and diagnostic colonoscopies (r: 18.5 -85.8%, p < 0.001). In the FIT-positive population (n Z 77.536), the mean percentages per endoscopy service for the following case-mix factors were significantly different: age higher than 65 years (r: 36.0 -62.7%, p < 0.001), male patients (r: 51.8 -67.3%, p Z 0.001) and ASA 3 or higher (r: 0.3 -30.8%, p < 0.001). The case-mix factors age, sex, ASA classification and indication for colonoscopy were significantly associated with CIR and ABPR. Age, sex and ASA classification were significantly associated with PDR in the FIT-positive population. The expected CIR, ABPR and PDR per endoscopy service ranged from 95.0% to 96.9%, from 93.5% to 96.4% and from 75.7% to 79.0%, respectively. Conclusion: Variation in case-mix factors between endoscopy services results in variation in expected outcomes for colonoscopy between these endoscopy services. Our findings emphasize that for comparison of colonoscopy performance measures between endoscopy services, adjustment for case-mix factors should be considered.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.