Quality of colonoscopy performed by medical or surgical specialists and trainees in five Australian hospitals  

作　　者：Tsai-Wing Ow Olga A Sukocheva Vy Tran Richard Lin Shawn Zhenhui Lee Matthew Chu Bianca Angelica Christopher K Rayner Edmund Tse Guru Iyngkaran Peter A Bampton 

机构地区：[1]Department of Gastroenterology and Hepatology,Royal Adelaide Hospital,Adelaide 5000,SA,Australia [2]Department of Gastroenterology and Hepatology,Flinders Medical Centre,Bedford Park 5042,SA,Australia [3]Department of Gastroenterology and Hepatology,The Queen Elizabeth Hospital,Woodville South 5011,SA,Australia [4]Department of Gastroenterology,Royal Darwin Hospital,Darwin 0810,NT,Australia [5]Department of Gastroenterology and Hepatology,Royal Melbourne Hospital,Parkville 3050,VIC,Australia

出　　处：《World Journal of Gastrointestinal Endoscopy》2022年第11期672-683,共12页世界胃肠内镜杂志（英文版）（电子版）

摘　　要：BACKGROUND Ensuring colonoscopy procedure quality is vital to the success of screening and surveillance programmes for bowel cancer in Australia. However, the data on the performance of quality metrics, through adequate adenoma detection, bowel preparation, and procedure completion rates, in the Australian public sector is limited. Understanding these can inform quality improvement to further strengthen our capacity for prevention and early detection of colorectal cancer.AIM To determine the quality of colonoscopy in Australian teaching hospitals and their association with proceduralist specialty, trainee involvement, and location.METHODS We retrospectively evaluated 2443 consecutive colonoscopy procedure reports from 1 January to 1 April, 2018 from five public teaching tertiary hospitals in Australia(median 60 years old, 49% male). Data for bowel preparation quality,procedure completion rates, and detection rates of clinically significant adenomas, conventional adenomas, and serrated lesions was collected and compared to national criteria for quality in colonoscopy. Participating hospital, proceduralist specialty, and trainee involvement indicators were used for stratification. Data was analysed using Chi-squared tests of independence, MannWhitney U, One-way ANOVA, and multivariate binary logistic regression.RESULTS Fifty-two point two percent(n = 1276) and 43.3%(n = 1057) were performed by medical and surgical proceduralists respectively, whilst 29.8%(n = 728) involved a trainee. Inadequate bowel preparation affected 7.3% of all procedures. The procedure completion rate was 95.1%, which increased to 97.5% after adjustment for bowel preparation quality. The pooled cancer, adenoma, and serrated lesion detection rates for all five hospitals were 3.5%, 40%, and 5.9% respectively. Assessed hospitals varied significantly by patient age(P < 0.001), work-force composition(P < 0.001), adequacy of bowel preparation(P < 0.001), and adenoma detection rate(P < 0.001). Two hospitals(40%) did not meet all national criteria fo

关 键 词：COLONOSCOPY Quality of health care Adenoma detection rate Bowel preparation quality Hospital-based teaching 

分 类 号：R197.323[医药卫生—卫生事业管理]