AIM： To complete a quality audit using recently pub- lished criteria from the Quality Assurance Task Group of the National Colorectal Cancer Roundtable. METHODS： Consecutive colonoscopy reports of patients at averag...AIM： To complete a quality audit using recently pub- lished criteria from the Quality Assurance Task Group of the National Colorectal Cancer Roundtable. METHODS： Consecutive colonoscopy reports of patients at average/high risk screening, or with a prior col6rectal neoplasia （CRN） by endoscopists who perform 11 000 procedures yearly, using a commercial computerized endoscopic report generator. A separate institutional da- tabase providing pathological results. Required documen- tation included patient demographics, history, procedure indications, technical descriptions, colonoscopy findings, interventions, unplanned events, follow-up plans, and pathology results. Reports abstraction employed a stan- dardized glossary with 10% independent data validation. Sample size calculations determined the number of re- ports needed.RESULTS： Two hundreds and fifty patients （63.2± 10.5 years, female： 42.8%, average risk： 38.5%, per- sonal/family history of CRN： 43.3%/20.2%） were scoped in June 2009 by 8 gastroenterologists and 3 surgeons （mean practice： 17.1 ± 8.5 years）. Procedural indica- tion and informed consent were always documented. 14% provided a previous colonoscopy date （past polyp removal information in 25%, but insufficient in most to determine surveillance intervals appropriateness）. Most procedural indicators were recorded （exam date： 98.4%, medications： 99.2%, difficulty level： 98.8%, prep quality： 99.6%）. All reports noted extent of visualization （cecum： 94.4%, with landmarks noted in 78.8% - photodocu- mentation： 67.2%）. No procedural times were recorded. One hundred and eleven had polyps （44.4%） with ana- tomic location noted in 99.1%, size in 65.8%, morphol- ogy in 62.2%; removal was by cold biopsy in 25.2% （cold snare： 18%, snare cautery： 31.5%, unrecorded： 20.7%）, 84.7% were retrieved. Adenomas were noted in 24.8% （advanced adenomas： 7.6%, cancer： 0.4%） in this population with varying previous colonic investigations. CONCLUSION： This audit reveals lacking reported ite- ms, justifying additional research to optimize quality of reporting.展开更多
基金Supported by The Research Scholar (Chercheur National) of the Fonds de la Recherche en Santé du Québec
文摘AIM： To complete a quality audit using recently pub- lished criteria from the Quality Assurance Task Group of the National Colorectal Cancer Roundtable. METHODS： Consecutive colonoscopy reports of patients at average/high risk screening, or with a prior col6rectal neoplasia （CRN） by endoscopists who perform 11 000 procedures yearly, using a commercial computerized endoscopic report generator. A separate institutional da- tabase providing pathological results. Required documen- tation included patient demographics, history, procedure indications, technical descriptions, colonoscopy findings, interventions, unplanned events, follow-up plans, and pathology results. Reports abstraction employed a stan- dardized glossary with 10% independent data validation. Sample size calculations determined the number of re- ports needed.RESULTS： Two hundreds and fifty patients （63.2± 10.5 years, female： 42.8%, average risk： 38.5%, per- sonal/family history of CRN： 43.3%/20.2%） were scoped in June 2009 by 8 gastroenterologists and 3 surgeons （mean practice： 17.1 ± 8.5 years）. Procedural indica- tion and informed consent were always documented. 14% provided a previous colonoscopy date （past polyp removal information in 25%, but insufficient in most to determine surveillance intervals appropriateness）. Most procedural indicators were recorded （exam date： 98.4%, medications： 99.2%, difficulty level： 98.8%, prep quality： 99.6%）. All reports noted extent of visualization （cecum： 94.4%, with landmarks noted in 78.8% - photodocu- mentation： 67.2%）. No procedural times were recorded. One hundred and eleven had polyps （44.4%） with ana- tomic location noted in 99.1%, size in 65.8%, morphol- ogy in 62.2%; removal was by cold biopsy in 25.2% （cold snare： 18%, snare cautery： 31.5%, unrecorded： 20.7%）, 84.7% were retrieved. Adenomas were noted in 24.8% （advanced adenomas： 7.6%, cancer： 0.4%） in this population with varying previous colonic investigations. CONCLUSION： This audit reveals lacking reported ite- ms, justifying additional research to optimize quality of reporting.
