Continuous monitoring of colonoscopy performance in the Netherlands: first results of a nationwide registry

Abstract

Background: To optimize colonoscopy quality, several performance measures have been developed. These are usually assessed without distinction between the indications for colonoscopy. This study aims to assess the feasibility of linkage between two registries: a national colonoscopy registry and a national registry for adverse events of gastrointestinal endoscopies in the Netherlands, and to describe the results of colonoscopy quality per indication. Methods: This retrospective study was conducted with prospectively collected data of the Dutch Gastrointestinal Endoscopy Audit (DGEA) and the Dutch Registration of Complications in Endoscopy (DRCE). Data between 01-01-2016 and 01-01-2019 were analyzed. To calculate adverse event rates, data were linked to the level of endoscopy service. Results: During the 3-year study period, 266.981 colonoscopies were recorded in DGEA. Of all indications, cecal intubation rate was highest in fecal immunochemical test (FIT)-positive screening colonoscopies (97.1%), followed by surveillance (93.2%), diagnostic (90.7%) and therapeutic colonoscopies (83.1%). The highest rate of adequate bowel preparation was observed in FIT-positive screening colonoscopies (97.1%). A total of 1540 (0.58%) adverse events occurred after colonoscopies. Perforation and bleeding rates were highest for therapeutic (0.51% and 1.56%, respectively) and FIT-positive screening colonoscopies (0.06% and 0.72%, respectively). The colonoscopy-related mortality was 0.006%. Conclusion: This study describes the first results of the Dutch national colonoscopy registry, which was successfully linked with data of the national registry for adverse events of gastrointestinal endoscopies. In this large dataset, performance measures varied per indication. Our results emphasize the importance of defining benchmarks per indication in future guidelines.

Adherence to European Society of Gastrointestinal Endoscopy Quality Performance Measures for Upper and Lower Gastrointestinal Endoscopy: A Nationwide Survey From the Italian Society of Digestive Endoscopy

“…Our study provides further evidence that the measurement of post-colonoscopy complications has only partially entered routine practice, as only half of the endoscopic centers report post-colonoscopy complications in Europe ( 21 , 22 ). In the Netherlands, where the Dutch national colonoscopy registry allows continuous monitoring of complications, post-colonoscopy complication rates are around 0.5%, which is the ESGE minimum standard ( 23 ).…”

How to track and register adverse events and incidents related to gastrointestinal endoscopy

“…The current study clearly highlights all these difficulties. Automated nationwide prospective registration of endoscopic procedures and outcomes may be the only reliable solution, as already successfully implemented in some countries (21)(22)(23)(24). This also accounts for the registration of anaesthesiology-related AE (25,26).…”

High quality colonoscopy: using textbook process as a composite quality measure

“…Procedures were excluded when patients were younger than 18 years. Data about adverse events (AEs) are recorded in the local and national AE registry [19]. Data from those registries were linked to the dataset.…”