Quality of colonoscopy in an organised colorectal cancer screening programme with immunochemical faecal occult blood test: the EQuIPE study (Evaluating Quality Indicators of the Performance of Endoscopy).
Gut
; 64(9): 1389-96, 2015 Sep.
Article
en En
| MEDLINE
| ID: mdl-25227521
ABSTRACT
OBJECTIVES:
To assess variation in the main colonoscopy quality indicators in organised colorectal cancer (CRC) screening programmes based on faecal immunochemical test (FIT).DESIGN:
Data from a case-series of colonoscopies of FIT-positive subjects were provided by 44 Italian CRC screening programmes. Data on screening history, endoscopic procedure and histology results, and additional information on the endoscopy centre and the endoscopists were collected. The adenoma detection rate (ADR) and caecal intubation rate (CIR) were assessed for the whole population and the individual endoscopists. To explore variation in the quality indicators, multilevel analyses were performed according to patient/centre/endoscopist characteristics.RESULTS:
We analysed 75â 569 (mean age 61.3â years; men 57%) colonoscopies for positive FIT performed by 479 endoscopists in 79 centres. ADR ranged from 13.5% to 75% among endoscopists (mean 44.8%). ADR was associated with gastroenterology specialty (OR 0.87 for others, 95% CI 0.76 to 0.96) and, at the endoscopy centre level, with the routine use of sedation (OR 0.80 if occasional (<33%); 95% CI 0.64 to 1.00) and availability of screening-dedicated sessions (OR 1.35; 95% CI 1.11 to 1.66). CIR ranged between 58.8% and 100% (mean 93.1%). Independent predictors of CIR at the endoscopist level were the yearly number of screening colonoscopies performed (OR 1.51 for endoscopists with >600 colonoscopies; 95% CI 1.11 to 2.04) and, at the endoscopy centre level, screening-dedicated sessions (OR 2.18; 95% CI 1.24 to 3.83) and higher rates of sedation (OR 0.47 if occasional; 95% CI 0.24 to 0.92).CONCLUSIONS:
The quality of colonoscopy was affected by patient-related, endoscopist-related and centre-related characteristics. Policies addressing organisational issues should improve the quality of colonoscopy in our programme and similar programmes.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Garantía de la Calidad de Atención de Salud
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Neoplasias Colorrectales
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Adenoma
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Colonoscopía
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Detección Precoz del Cáncer
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Sangre Oculta
Tipo de estudio:
Clinical_trials
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Diagnostic_studies
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Etiology_studies
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Evaluation_studies
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Incidence_studies
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Prognostic_studies
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Risk_factors_studies
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Screening_studies
Límite:
Aged
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Female
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Humans
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Male
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Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
Gut
Año:
2015
Tipo del documento:
Article
País de afiliación:
Italia