Case-mix adjustment to compare colonoscopy performance between endoscopy centers: a nationwide registry study.
Endoscopy
; 54(5): 455-462, 2022 05.
Article
em En
| MEDLINE
| ID: mdl-34488227
ABSTRACT
BACKGROUND:
Nonmodifiable patient and endoscopy characteristics might influence colonoscopy performance. Differences in these so-called case-mix factors are likely to exist between endoscopy centers. This study aimed to examine the importance of case-mix adjustment when comparing performance between endoscopy centers.METHODS:
Prospectively collected data recorded in the Dutch national colonoscopy registry between 2016 and 2019 were retrospectively analyzed. Cecal intubation rate (CIR) and adequate bowel preparation rate (ABPR) were analyzed. Additionally, polyp detection rate (PDR) was studied in screening colonoscopies following a positive fecal immunochemical test (FIT). Variation in case-mix factors between endoscopy centers and expected outcomes for each performance measure were calculated per endoscopy center based on case-mix factors (sex, age, American Society of Anesthesiologist [ASA] score, indication) using multivariable logistic regression.RESULTS:
363â 840 colonoscopies were included from 51 endoscopy centers. Mean percentages per endoscopy center were significantly different for age >â65 years, male patients, ASAâ≥âIII, and diagnostic colonoscopies (all Pâ<â0.001). In the FIT-positive screening population, significant differences were observed between endoscopy centers for age >â65 years, male patients, and ASAâ≥âIII (all Pâ≤â0.001). The expected CIR, ABPR, and PDR ranged from 95.0â% to 96.9â%, from 93.6â% to 96.4â%, and from 76.2â% to 79.1â%, respectively. Age, sex, ASA classification, and indication were significant case-mix factors for CIR and ABPR. In the FIT-positive screening population, age, sex, and ASA classification were significant case-mix factors for PDR.CONCLUSION:
Our findings emphasize the importance of considering case-mix adjustment when comparing colonoscopy performance measures between endoscopy centers.
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Base de dados:
MEDLINE
Assunto principal:
Neoplasias Colorretais
/
Adenoma
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
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Observational_studies
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Risk_factors_studies
Limite:
Aged
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Humans
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Male
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article