Colonoscopy: Practice variation among 69 hospital-based endoscopists

Cotton, Peter B.; Connor, Patrick; McGee, Daniel; Jowell, Paul S.; Nickl, Nick; Schutz, Stephen M.; Leung, Joseph; Lee, John; Libby, Eric

doi:10.1067/mge.2003.121

Cited by 106 publications

(72 citation statements)

References 31 publications

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“…While data from the late 1990s revealed that this benchmark was achieved in only 55% of practitioners in North America 31 , more recent evidence suggest improved cecal intubation rates; a study of 10…”

Section: Cecal Intubation Ratementioning

confidence: 99%

Colonoscopy Quality Assessment

Fayad

Kahi

2015

Gastrointestinal Endoscopy Clinics of North America

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Abstract:Colonoscopy is the cornerstone of colorectal cancer screening programs. There is significant variability in the quality of colonoscopy between endoscopists. Colonoscopy quality assessment tracks various metrics in order to improve the effectiveness of colonoscopy, aiming at reducing the incidence and mortality from colorectal cancer. Adenoma detection rate is the prime metric, as it is associated with the risk of interval cancers. Implementing processes to measure and improve the adenoma detection rate is essential to improve the quality of colonoscopy.

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Section: Cecal Intubation Ratementioning

confidence: 99%

Colonoscopy Quality Assessment

Fayad

Kahi

2015

Gastrointestinal Endoscopy Clinics of North America

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“…25 The largest study of colonoscopy reporting also found that the frequency of normal examinations varied from less than 10% to greater than 40%. 15 The authors speculate that this may have been due to endoscopists having different thresholds and indications for doing a colonoscopy. Our study used a joint waiting list, yet the frequency of normal examinations for colonoscopy varied from 23-55%.…”

Section: Variations In the Reporting Of Endoscopies By Different Endomentioning

confidence: 97%

“…15 Our own endoscopists found polyps in 14-45% of cases (all indications). The variation in polyp reporting is of concern as it may have serious implications for the patients' future health.…”

Section: Variations In the Reporting Of Endoscopies By Different Endomentioning

confidence: 99%

“…15,23,24 When experienced endoscopists review photographs purporting to show caecal landmarks, there is considerable disagreement as to whether the photographs document total colonoscopy. 24 In all the studies, caecal intubation rates differed widely between endoscopists as they did in the present study.…”

Section: Variations In the Reporting Of Endoscopies By Different Endomentioning

confidence: 99%

“…11,12,13 Some evidence suggests that there may be considerable variability in interpreting endoscopic appearances, with potentially important clinical consequences. 14,15 Many of the published studies concentrate on 'expert' endoscopists looking at relatively small numbers of patients. The specific aim of this study was, therefore, to study the variability of endoscopic reporting in general clinical practice.…”

Section: Introductionmentioning

confidence: 99%

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Variations in the reporting of endoscopies by different endoscopists

2007

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-All gastroscopies and colonoscopies performed in two UK teaching hospitals over a period of one year were audited to investigate whether endoscopic reporting of gastroscopies and colonoscopies by different endoscopists is consistent. Endoscopic diagnoses were retrieved from the hospitals' endoscopy databases. The results of 1,814 colonoscopies and 2,127 gastroscopies were analysed using χ 2 (Chi squared). The frequency of reporting common diagnoses was variable and the differences between specialist endoscopists were highly significant, including for important conditions such as peptic ulceration (range 2-10%, p=0.001) and colonic polyps (16-45%, p<0.0001). There is a large variation in the frequency of the diagnoses reported by different endoscopists. This is unlikely to be explained by casemix or chance. This may have major implications for the health of patients. More emphasis must be placed during training on the correct interpretation of endoscopies.

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