Pre- and post-procedural quality indicators for colonoscopy: A nationwide survey

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• 作者：Silvia Paggi^a ; ^{silviapagg@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Arnaldo Amato^a ; Andrea Anderloni^b ; Vito Annese^c ; Luca Barresi^d ; Andrea Buda^e ; Paola Cesaro^f ; Emilio Di Giulio^g ; Giuseppe Gullotti^h ; Carlo Fabbriⁱ ; Giancarla Fiori^j ; Lorenzo Fuccio^k ; Mauro Manno^l ; Alessandro Musso^m ; Emanuele Rondonotti^a ; Cristina Trovato^j ; Cesare Hassanⁿ ; Alessandro Repici^b ; ^o ; Franco Radaelli^a ; on behalf of the Bowell Group
• 关键词：Colonoscopy ; Practice guidelines ; Quality
• 刊名：Digestive and Liver Disease
• 出版年：2016
• 出版时间：July 2016
• 年：2016
• 卷：48
• 期：7
• 页码：759-764
• 全文大小：445 K

文摘

The provision of high-quality colonoscopy can be assessed by evaluating technical aspects of the procedure and, at individual center level, by comparing structural indicators and institutional policies for managing peri-procedural issues with guideline recommendations.

Aim

To assess the colonoscopy quality (CQ) in Italy at center level.

Methods

Gastroenterologists participating in a nationwide colonoscopy education initiative provided information on structural indicators of their centers and on institutional policies by answering 10 multiple-choice clinical scenarios. Practice variation across centers and compliance with guidelines were analyzed.

Results

Data from 282 Italian centers were evaluated. Overall, a significant proportion of centers did not meet CQ standards as concerns endoscopy facilities and equipments (e.g., dedicated recovery room, dirty-to-clean path, reporting software). CQ assurance programs were implemented in only 25% of centers. Concerning peri-procedural issues, main discrepancies with guidelines were recorded in the underuse of split-dose preparation (routinely adopted by 18% of centers), the routine request of coagulation tests prior to colonoscopy (30%), the routine interruption of aspirin for polypectomy (18%), and the adoption of 3-year surveillance for low-risk adenoma (49%).

Conclusions

Present survey shows a significant variation in the CQ of endoscopy centers in Italy on many items of colonoscopy practice that should be targeted for future interventions.