Variation of quality of colonoscopy in Italy over five years: A nation-wide observational study

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• 作者：Franco Radaelli¹ ; ^{francoradaelli@virgilio.it} ; Silvia Paggi¹ ; Giorgio Minoli¹
• 关键词：Colonoscopy ; Quality indicators
• 刊名：Digestive and Liver Disease
• 出版年：2013
• 出版时间：January, 2013
• 年：2013
• 卷：45
• 期：1
• 页码：28-32
• 全文大小：287 K

文摘

Background/aim

A nation-wide survey of colonoscopy practice carried out in 2004 showed disappointing data on colonoscopy quality in Italy. Present study was aimed prospectively at re-evaluating quality indicators of colonoscopy and their changes over a five-year-period.

Methods

The main features of each Endoscopy Unit and performance indicators on consecutive colonoscopies performed in a 2-week period were recorded. Variation of colonoscopy quality was assessed by comparing caecal-intubation and polyp-detection rates in present survey with those collected five-years before; statistical analysis was restricted to centres participating in both data collections.

Results

6158 colonoscopies from 116 centres were evaluated; unadjusted caecal-intubation rate was 83.0 % , with 21.6 % centres reporting a value >90 % ; mean polyp-detection rate was 32.0 % (range 9.6-71.2 % across centres). To assess variation of performance indicators, 4452 procedures from 77 centres were compared to 3589 procedures performed five-years before, in the same centres. A significant difference between the two rounds of data collections was observed for both caecal-intubation (82.6 % versus 80.9 % , p = 0.043) and polyp-detection (31.3 % versus 28.1 % , p = 0.002). However, 52 centres maintained a caecal-intubation rate constantly <90 % .

Conclusions

Present data show that colonoscopy in Italy is still far below quality standards and that a significant improvement of practice did not occur over the last five years. Strategies to enhance colonoscopy quality should be pursued by professional societies.