Factors associated with the technical performance of colonoscopy: An EPAGE study.

JK Harris, F Froehlich, V Wietlisbach, B Burnand, J-J Gonvers, J-P Vader, Cecilia Benoni, The EPAGE study group

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Background

    Variations in colonoscopy practice exist, which may be related to healthcare quality.
    Aims

    To determine factors associated with three performance indicators of colonoscopy: complete colonoscopy, adenomatous polyp diagnosis, and duration.
    Patients

    Consecutive patients referred for colonoscopy from 21 centres in 11 countries.
    Methods

    This prospective observational study used multiple variable regression analyses to identify determinants of the quality indicators.
    Results

    Six thousand and four patients were included in the study. Patients from private, open-access centres (odds ratio: 3.17, 95% confidence interval: 1.87–5.38) were more likely to have a complete colonoscopy than patients from public, gatekeeper centres. Patients from centres where over 50% of the endoscopists were of senior rank were roughly twice as likely to have an adenoma diagnosed, and longer average withdrawal duration (odds ratio: 1.08, 95% confidence interval: 1.07–1.09) was associated with more frequent adenoma diagnoses. Patients who had difficulty during colonoscopy had longer durations to caecum (time ratio: 2.87, 95% confidence interval: 2.72–3.01) and withdrawal durations (time ratio: 1.26, 95% confidence interval: 1.18–1.33) than patients who had no difficulties.
    Conclusions

    Multiple factors have been identified as being associated with key quality indicators. The non-modifiable factors permit the identification of patients who may be at greater risk of not having quality colonoscopy, while changes to the modifiable factors may help improve the quality of colonoscopy.
    Original languageEnglish
    Pages (from-to)678-689
    JournalDigestive and Liver Disease
    Volume39
    Issue number7
    DOIs
    Publication statusPublished - 2007

    Subject classification (UKÄ)

    • Rheumatology and Autoimmunity

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