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Gastrointest Endosc. 2011 Mar;73(3):498-506. doi: 10.1016/j.gie.2010.08.008.

Polypectomy rate as a quality measure for colonoscopy.

Author information

1
Division of Gastroenterology, Oregon Health and Science University, Portland, Oregon, USA.

Abstract

BACKGROUND:

The adenoma detection rate (ADR) has been proposed as a robust quality indicator for colonoscopy, but it is cumbersome to calculate and not available at the time of colonoscopy.

OBJECTIVE:

To determine whether endoscopists' polypectomy rates (PRs) correlate with their ADRs and to calculate benchmark PRs that correlate with benchmark ADRs.

DESIGN:

Retrospective study.

SETTING:

University and Veterans Affairs endoscopy units in Portland, Oregon.

SUBJECTS:

Fifteen endoscopists and their patients.

MAIN OUTCOME MEASUREMENTS:

Proportion of patients with any adenoma and any polyp removed; correlation between ADRs and PRs.

RESULTS:

Fifteen endoscopists performed 2706 average-risk screening colonoscopies during the study. There was variation in the ADR for men (15.4%-44.7%) and women (6.1%-25.8%) and in the PRs for men (17.9%-66.0%) and women (11.3%-43.1%). Endoscopists' PRs correlated well with their ADRs (r(s) = 0.86, P < .001). To attain the established benchmark ADRs for men (25%) and women (15%), endoscopists needed PRs of 40% and 30%, respectively. Endoscopists attaining the benchmark PRs had a higher ADR among men (32.1% vs 18.4%, P < .001) and a higher ADR among women (21.0% vs 9.8%, P = .01) than those who did not.

LIMITATIONS:

Study endoscopists' approach to polypectomy may differ from that of endoscopists in other settings.

CONCLUSIONS:

The PR is a useful quality measure with a high degree of correlation with the ADR.

PMID:
20970795
DOI:
10.1016/j.gie.2010.08.008
[Indexed for MEDLINE]
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