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Quality Indicators for Colonoscopy

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Colorectal Cancer Screening

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Abstract

Colonoscopy has become the screening test of choice for many gastroenterologists and patients, yet population studies have demonstrated that its protective effects are not as robust as previously thought. Interval cancers have been shown to be more prevalent than once thought, as a result of several factors. One of these is the adenoma detection rate (ADR). ADR is a very strong measure of colonoscopy performance quality that correlates with subsequent cancer risk. Detection of adenomas and other key issues in quality assurance for colonoscopy are now being addressed through joint efforts by several national medical and gastroenterologic societies. A list of proposed quality indicators has been created, with each measure well supported by evidence-based studies. Indicators that are discussed in more detail are the ADR, withdrawal time, cecal intubation rate, proper standardized colonoscopy reporting, and adequate bowel preparation. Lastly, accountability measures are now being implemented with national endorsement by the National Quality Forum (NQF) and the Centers for Medicare and Medicaid. A pay for performance model is a strategy that aims to encourage and reward high-quality health care. The Physician Quality Reporting System (PQRS) uses a combination of incentive payments and payment adjustments to encourage reporting of quality information by professionals. Health-care providers have a vital responsibility to provide optimal health care to patients. Well-supported quality indicators in colonoscopy are now available to help ensure that our patients receive the best care possible for their colon.

Excerpt reprinted from Quality improvement of gastrointestinal endoscopy: guidelines for clinical application. From the ASGE. American Society for Gastrointestinal Endoscopy. Gastrointest Endosc. 1999;49(6):842–4. With permission from Elsevier.

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Author information

Authors and Affiliations

  1. Department of Gastroenterology, Mayo Clinic, Jacksonville, FL, USA

    Victoria Gómez MD

  2. Department of Gastroenterology and Hepatology, Mayo Clinic Florida, 4500 San Pablo Rd., 32224, Jacksonville, FL, USA

    Michael Bradley Wallace MD, MPH

Authors
  1. Victoria Gómez MD
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  2. Michael Bradley Wallace MD, MPH
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Correspondence to Michael Bradley Wallace MD, MPH .

Editor information

Editors and Affiliations

  1. Department of Gastroenterology, Minneapolis VA Medical Center, Minneapolis, Minnesota, USA

    Aasma Shaukat

  2. Department of Medicine, Yale University, New Haven, Connecticut, USA

    John I. Allen

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Gómez, V., Bradley Wallace, M. (2015). Quality Indicators for Colonoscopy. In: Shaukat, A., Allen, J. (eds) Colorectal Cancer Screening. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2333-5_7

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  • DOI: https://doi.org/10.1007/978-1-4939-2333-5_7

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