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  • Title: Polypectomy rate as a quality measure for colonoscopy.
    Author: Williams JE, Le TD, Faigel DO.
    Journal: Gastrointest Endosc; 2011 Mar; 73(3):498-506. PubMed ID: 20970795.
    Abstract:
    BACKGROUND: The adenoma detection rate (ADR) has been proposed as a robust quality indicator for colonoscopy, but it is cumbersome to calculate and not available at the time of colonoscopy. OBJECTIVE: To determine whether endoscopists' polypectomy rates (PRs) correlate with their ADRs and to calculate benchmark PRs that correlate with benchmark ADRs. DESIGN: Retrospective study. SETTING: University and Veterans Affairs endoscopy units in Portland, Oregon. SUBJECTS: Fifteen endoscopists and their patients. MAIN OUTCOME MEASUREMENTS: Proportion of patients with any adenoma and any polyp removed; correlation between ADRs and PRs. RESULTS: Fifteen endoscopists performed 2706 average-risk screening colonoscopies during the study. There was variation in the ADR for men (15.4%-44.7%) and women (6.1%-25.8%) and in the PRs for men (17.9%-66.0%) and women (11.3%-43.1%). Endoscopists' PRs correlated well with their ADRs (r(s) = 0.86, P < .001). To attain the established benchmark ADRs for men (25%) and women (15%), endoscopists needed PRs of 40% and 30%, respectively. Endoscopists attaining the benchmark PRs had a higher ADR among men (32.1% vs 18.4%, P < .001) and a higher ADR among women (21.0% vs 9.8%, P = .01) than those who did not. LIMITATIONS: Study endoscopists' approach to polypectomy may differ from that of endoscopists in other settings. CONCLUSIONS: The PR is a useful quality measure with a high degree of correlation with the ADR.
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