A multicenter pragmatic study of an evidence-based intervention to improve adenoma detection: the Quality Improvement in Colonoscopy (QIC) study

Rajasekhar, PT; Rees, Colin; Mg, Bramble; Wilson, D. W.; Rutter,; Saunders, BP; Hungin, A. P. S.; East, JE

doi:10.1055/s-0034-1391563

Cited by 43 publications

(29 citation statements)

References 23 publications

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“…Therefore, guidelines recommend at least 6 min of withdrawal time as a quality marker [4,46,47]. Longer withdrawal times frequently result in a higher ADR just as data from the QIC study demonstrate [48]. There are several studies that underline this important finding [49,50].…”

Section: Factors Influencing the Adrmentioning

confidence: 99%

Endoscopic Improvement of the Adenoma Detection Rate during Colonoscopy - Where Do We Stand in 2015?

Floer

Meister²

2016

Digestion

238

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Background: The presence of colorectal adenomas is considered a major risk factor for colorectal cancer development. The implementation of screening colonoscopy programs in the Western world has led to a substantial reduction of colorectal cancer death. Many efforts have been made to reduce the adenoma miss rates by the application of new endoscopic devices and techniques for better adenoma visualization. Summary: This special review gives the readership an overview of current endoscopic innovations that can aid in the increase of the adenoma detection rate (ADR) during colonoscopy. These innovations include the use of devices like EndoCuff® and EndoRings® as well as new technical equipment like third-eye endoscope® and full-spectrum endoscopy (FUSE®). Key Message: Technical improvements and newly developed accessories are able to improve the ADR. However, additional costs and a willingness to invest into potentially expensive equipment might be necessary. Investigator-dependent skills remain the backbone in the ADR detection.

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Section: Factors Influencing the Adrmentioning

confidence: 99%

Endoscopic Improvement of the Adenoma Detection Rate during Colonoscopy - Where Do We Stand in 2015?

Floer

Meister²

2016

Digestion

238

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“…A recent large multicenter study from the UK (Quality Improvement in Colonoscopy study) found that implementation of a bundle of measures (e.g. withdrawal time ≥6 min, use of butylscopolamine, position change during colonoscopy to optimize visualization, and rectal retroflexion) improves adenoma detection rates . To improve uniformity in surveillance practice, the post‐polypectomy surveillance guidelines of the ESGE recommend risk stratification in two groups: (i) low‐risk group, which consists of patients with one or two non‐advanced adenomas versus (ii) high‐risk group, which consists of patients with ≥three adenomas or ≥one advanced adenoma (≥10 mm, villous histology or high‐grade dysplasia).…”

Section: Detection and Resection Of Colorectal Neoplasmsmentioning

confidence: 99%

Optimizing post‐polypectomy surveillance: A practical guide for the endoscopist

Bogie

Sanduleanu

2015

Digestive Endoscopy

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Several gastrointestinal societies strongly recommend colonoscopy surveillance after endoscopic and surgical resection of colorectal neoplasms. Common denominators to these recommendations include: high-quality baseline colonoscopy before inclusion in a surveillance program; risk stratification based on clinicopathological profiles to guide surveillance intervals; and endoscopist responsibility for providing surveillance advice. Considerable variability also exists between guidelines (i.e. regarding risk classification and surveillance intervals). In this review, we examine key factors for quality of post-polypectomy surveillance practice, in particular bowel preparation, endoscopic findings at baseline examination and adherence to surveillance recommendations. Frequently asked questions by the practising endoscopist are addressed.

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“…Many of the strategies for improving the quality in colonoscopy have an evidence base to support them 4. Interventional ‘bundles’ have already been used to try to increase quality markers such as ADR 25. Introduction with feedback of a ‘bundle’ (withdrawal time >6 mins, use of buscopan, rectal retroflexion and dynamic position changes) improved detection, especially among poor performers, with benefits maintained for 3 years postintervention 26.…”

Section: Introductionmentioning

confidence: 99%

British society of gastroenterology Endoscopy Quality Improvement Programme (EQIP): overview and progress

Rees¹,

Koo²,

Anderson

et al. 2019

Frontline Gastroenterol

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High quality gastrointestinal (GI) endoscopy improves patient care. Raising standards in endoscopy improves diagnostic accuracy, management of pathology and ultimately improves outcomes. Historical identification of significant variation in colonoscopy quality led to the development of the Joint Advisory Group (JAG) on GI Endoscopy, the Global Rating Scale (GRS), JAG Endoscopy Training System (JETS) training and certification. These measures led to major improvements in UK endoscopy but significant variation in practice still exists. To improve quality further the British Society of Gastroenterology Endoscopy Quality Improvement (EQIP) has been established with the aim of raising quality and reducing variation in the quality of UK endoscopy. A multifaceted approach to quality improvement (QI) will be undertaken and is described in this manuscript. Upper GI EQIP will support adoption of standards alongside regional upskilling courses. Lower GI EQIP will focus on supporting endoscopists to achieve current standards alongside approaches to reducing postcolonoscopy colorectal cancer rates. Endoscopic retrograde cholangiopancreatography EQIP will adopt a regional approach of using local data to support network-based QI. Newer areas of endoscopy practice such as small bowel endoscopy and endoscopic ultrasound will focus on identifying key performance indicators as well as standardising training and accreditation pathways. EQIP will also support QI in management of GI bleeding as well as standardising the approach to new techniques and technologies. Where evidence is lacking, approaches to gather new evidence and support the translation into clinical practice will be supported.

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A multicenter pragmatic study of an evidence-based intervention to improve adenoma detection: the Quality Improvement in Colonoscopy (QIC) study

Abstract: In routine clinical practice, introduction of a simple, inexpensive, evidence-based "bundle" of measures is feasible and is associated with higher global ADR, driven by improvements amongst the poorest performing colonoscopists.

Cited by 43 publications

References 23 publications

Endoscopic Improvement of the Adenoma Detection Rate during Colonoscopy - Where Do We Stand in 2015?

Endoscopic Improvement of the Adenoma Detection Rate during Colonoscopy - Where Do We Stand in 2015?

Optimizing post‐polypectomy surveillance: A practical guide for the endoscopist

British society of gastroenterology Endoscopy Quality Improvement Programme (EQIP): overview and progress

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