Assessment of the quality of colonoscopy reports: results from a multicenter consortium.
Assessment of the quality of colonoscopy reports: results from a multicenter consortium.
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DOI：
10.1016/j.gie.2008.08.034
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发表时间：
2009-03
影响因子：
7.7
通讯作者：
Nadel, Marion
中科院分区：
文献类型：
--
作者：
Lieberman, David A.;Faigel, Douglas O.;Logan, Judith R.;Mattek, Nora;Holub, Jennifer;Eisen, Glenn;Morris, Cynthia;Smith, Robert;Nadel, Marion
为了提高结肠镜检查质量，报告必须包括可监测的关键质量指标。确定不同实践环境中结肠镜检查报告的质量。临床结果研究计划 (CORI) 联盟，包括美国 73 个胃肠病学实践中心，这些中心使用结构化计算机内窥镜报告生成器，其中包括特定质量指标的字段。 2004 年至 2006 年的前瞻性数据收集。查询报告以确定是否记录了具体的质量指标。在每年超过 100 次结肠镜检查的 53 家诊所中，对具体终点进行了比较，包括肠道准备质量、盲肠插管率和筛查检查中息肉 >9 毫米的检出率。在研究期间收到的 438,521 份报告中，13.9% 不包括肠道准备质量，10.1% 不包括合并症分类。总体盲肠插管率为 96.3%，但 14% 的报告未记录盲肠标志。缺失的息肉描述符包括息肉大小（4.9%）和形态（14.7%）。手术期间不良事件干预的报告从 0% 到 6.5% 不等。在接受筛查检查的平均风险患者中，经年龄、性别和种族调整后，息肉 >9mm 的检出率在 81% 的诊所中为 4% 至 10%。由于计算机报告生成器的标准使用而导致报告率偏高。尽管使用了计算机报告生成器，但不同实践中结肠镜检查报告的质量存在显着差异。临床实践中质量指标的测量可以确定质量改进的领域。
In order to improve colonoscopy quality, reports must include key quality indicators which can be monitored. To determine the quality of colonoscopy reports in diverse practice settings. The consortium of the Clinical Outcomes Research Initiative (CORI), which includes 73 gastroenterology practice sites in the United States which use a structured computerized endoscopy report generator, which includes fields for specific quality indicators. Prospective data collection from 2004 to 2006. Reports were queried to determine if specific quality indicators were recorded. Specific endpoints, including quality of bowel prep, cecal intubation rate and detection of polyp(s) >9mm in screening exams were compared in 53 practices with more than 100 colonoscopy procedures per year. Of the 438,521 reports received during the study period, 13.9% did not include bowel prep quality and 10.1% did not include co-morbidity classification. The overall cecal intubation rate was 96.3%, but cecal landmarks were not recorded in 14% of reports. Missing polyp descriptors included polyp size (4.9%) and morphology (14.7%). Report of interventions for adverse events during the procedure varied from 0 to 6.5%. Among average-risk patients receiving screening exams, the detection rate of polyps >9mm, adjusted for age, gender and race, was between 4 and 10% in 81% of practices. Bias toward high rates of reporting because of standard use of a computerized report generator. There is significant variation in quality of colonoscopy reports across diverse practices, despite the use of a computerized report generator. Measurement of quality indicators in clinical practice can identify areas for quality improvement.
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影响因子：
158.5
作者：
Bertagnolli, Monica M.;Eagle, Craig J.;Hawk, Ernest T.
通讯作者：
Hawk, Ernest T.
影响因子：
7.7
作者：
Lieberman, David;Nadel, Marion;Winawer, Sidney
通讯作者：
Winawer, Sidney
影响因子：
29.4
作者：
Sawhney, Mandeep S.;Farrar, William D.;Bond, John H.
通讯作者：
Bond, John H.
影响因子：
7.7
作者：
Korman, LY;Overholt, BF;Winker, CK
通讯作者：
Winker, CK
影响因子：
158.5
作者：
Pickhardt, PJ;Choi, JR;Schindler, WR
通讯作者：
Schindler, WR