MDL gastroenterologist (OR, 5.53; 95% CI, 3.28-9.32), and presence of 3 or more adenomas (OR, 2.97; 95% CI, 1.29-6.85). Attendance among patients with adenomas varied among departments, from 60% to 89% (P < .01), and was not associated with awareness of patients about their recommendations per department (P = .59). CONCLUSIONS: Not enough patients (only 85%) who receive colonoscopies are aware of their results or surveillance recommendations. Although awareness of findings and recommendations did not correlate with follow-up attendance, patients should be better informed about findings and their need for surveillance. Quality evaluation of colonoscopy reporting and colonoscopy perfomance in daily clinical practice. de Jonge V, Sint Nicolaas J, Cahen DL, Moolenaar W, Ouwendijk RJ, Tang TJ, van Tilburg AJP, Kuipers EJ, van Leerdam ME; SCoPE Consortium. Gastrointest Endosc. 2012 Jan;75(1):98-106. PMID: 21907986. BACKGROUND: Comprehensive monitoring of colonoscopy quality requires complete and accurate colonoscopy reporting. OBJECTIVE: This study aimed to assess the compliance with colonoscopy reporting and to assess the quality of colonoscopy performance. DESIGN: Consecutive colonoscopy reports were reviewed by hand. Four hundred reports were included from each department. SETTING: Daily clinical practice in 12 Dutch endoscopy departments. PATIENTS: Consecutive patients undergoing scheduled colonoscopy procedures. MAIN OUTCOME MEASUREMENTS: Quality of reporting was assessed by using the American Society for Gastrointestinal Endoscopy criteria for colonoscopy reporting. Quality of colonoscopy performance was evaluated by using the cecal intubation rate and adenoma detection rate (ADR). RESULTS: A total of 4800 colonoscopies were performed by 116 endoscopists: 70% by gastroenterologists, 16% by gastroenterology fellows, 10% by internists, 3% by nurseendoscopists, and 1% by surgeons. The mean age of the patients was 59 years (standard deviation 16), and 47% were male. Reports contained information on indication, sedation practice, and extent of the procedure in more than 90%. Only 62% of the reports mentioned the quality of bowel preparation (range between departments 7%-100%); photographic documentation of the cecal landmarks was present in 71% (range 22%-97%). The adjusted cecal intubation rate was 92% (range 84%-97%). The ADR was 24% (range 13%-32%). LIMITATIONS: Dependent on reports, no intervention in endoscopic practice. No analysis for performance per endoscopist. CONCLUSION: Colonoscopy reporting varied significantly in clinical practice. Colonoscopy performance met the suggested standards; however, considerable variability between endoscopy departments was found. The results of this study underline the importance of the implementation of quality indicators and guidelines. Moreover, by continuous monitoring of quality parameters, the quality of both colonoscopy reporting and colonoscopy performance can easily be improved. COMMENT IN: Quality benchmarking for colonoscopy: how do we pick products from the shelf? [Gastrointest Endosc. 2012]. 65 WETENSCHAPPELIJK jaarverslag 2012 Pagina 64
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