• 作者：Antonio Sá ; nchez del R&#237 ; o^a ; ^{asanchez@hospiten.es} ; Juan Salvador Baudet^b ; Antonio Naranjo Rodr&#237 ; guez^c ; Rafael Campo Ferná ; ndez de los R&#237 ; os^d ; Inmaculada Salces Franco^e ; Jose Ramó ; n Aparicio Tormo^f ; Diego Sá ; nchez Muñ ; oz^g ; Joseph Llach^h ; Antonio Hervá ; s Molina^c ; Adolfo Parra-Blancoⁱ ; Juan Antonio D&#237 ; az Acostaⁱ ; los miembros del Grupo de Calidad en Endoscopia de la Asociació ; n Españ ; ola de Gastroenterologí ; a
• 关键词：Colonoscopia ; Indicadores de calidad ; Está ; ndares de referencia
• 刊名：Medicina Cl铆nica
• 出版年：2010
• 期刊代码：pca254_00257753
• 类别：med
• 出版时间：30 January 2010
• 卷：134
• 期：2
• 页码：49-56
• 文件大小：170 K

Background and objectives

Before starting programs for colorectal cancer screening it is necessary to evaluate the quality of colonoscopy. Our objectives were to develop a group of quality indicators of colonoscopy easily applicable and to determine the variability of their achievement.

Patients and methods

After reviewing the bibliography we prepared 21 potential indicators of quality that were submitted to a process of selection in which we measured their facial validity, content validity, reliability and viability of their measurement. We estimated the variability of their achievement by means of the coefficient of variability (CV) and the variability of the achievement of the standards by means of 蠂².

Results

Six indicators overcome the selection process: informed consent, medication administered, completed colonoscopy, complications, every polyp removed and recovered, and adenoma detection rate in patients older than 50 years. 1928 colonoscopies were included from eight endoscopy units. Every unit included the same number of colonoscopies selected by means of simple random sampling with substitution. There was an important variability in the achievement of some indicators and standards: medication administered (CV 43%, p<0.01), complications registered (CV 37%, p<0.01), every polyp removed and recovered (CV 12%, p<0.01) and adenoma detection rate in older than fifty years (CV 2%, p<0.01).

Conclusions

We have validated six quality indicators for colonoscopy which are easily measurable. An important variability exists in the achievement of some indicators and standards. Our data highlight the importance of the development of continuous quality improvement programmes for colonoscopy before starting colorectal cancer screening.