Post written by Simon C. Mathews, MD, from the Johns Hopkins University School of Medicine, Department of Medicine, Division of Gastroenterology and Hepatology, and the Johns Hopkins Medicine Armst.rong Institute for Patient Safety and Quality, Baltimore, Maryland, USA.
Our basic aim was to determine whether metrics for colonoscopy quality have improved over time. Research, education, and publication around quality metrics greatly increased and matured over the 15-year span of our study period. As a result, we wanted to determine if these factors translated into tangible improvement in outcomes.
Our study is the largest and longest evaluation of colonoscopy quality outcomes to date. It evaluated over 1.5 million adults over a 15-year time period. We found that colonoscopy outcomes as measured by bowel preparation quality, finding a polyp, finding 2 or more polyps, and finding polyps >9 mm improved significantly over the 15-year period between 2000 and 2014. While there was heterogeneity across metric types and indication groups, the greatest and most consistent improvements were seen in the average-risk screening population. These findings suggest that multifactorial efforts over the past decade are improving colonoscopy quality. Future evaluations should incorporate integration of histology-based quality metrics such as adenoma detection rate.
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