Abstract
The European Colonoscopy Quality Investigation (ECQI) Group aims to raise awareness for improvement in colonoscopy standards across Europe. We analyzed data collected on a sample of procedures conducted across Europe to evaluate the achievement of the European Society of Gastrointestinal Endoscopy (ESGE) mean withdrawal time (WT) target. We also investigated factors associated with WT, in the hope of establishing areas that could lead to a quality improvement. Methods: 6445 form completions from 12 countries between 2 June 2016 and 30 April 2018 were considered for this analysis. We performed an exploratory analysis looking at WT according to the ESGE definition. Stepwise multivariable logistic regression analysis was conducted to determine the most influential associated factors after adjusting for the other pre-specified variables. Results: In 1150 qualifying colonoscopies, the mean WT was 7.8 min. Stepwise analysis, including 587 procedures where all inputs were known, found that the variables most associated with mean WT were a previous total colonoscopy in the last five years (p = 0.0011) and the time of day the colonoscopy was performed (p = 0.0192). The main factor associated with a WT < 6 min was the time of day that a colonoscopy was performed. Use of sedation was the main factor associated with a higher propor-tion of WT > 10 min, along with a previous colonoscopy. Conclusions: On average, the sample of European practice captured by the ECQI survey met the minimum standard set by the ESGE. How-ever, there was variation and potential for improvement.
| Original language | English |
|---|---|
| Article number | 503 |
| Number of pages | 14 |
| Journal | Diagnostics |
| Volume | 12 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - Feb 2022 |
| Publication type | A1 Journal article-refereed |
Funding
Acknowledgments: The ECQI Group is grateful for the continued financial support provided by Norgine Ltd. In October 2016, the ECQI Group became an independent working party, free to obtain funding from any reputable source. The authors greatly acknowledge the support from Bharat Am-lani (employee of Norgine). Whilst it is not possible to acknowledge everyone individually, we are indebted and grateful to all of those who took the time to complete our questionnaires and provide an insight into their real-world practice. We would like to thank the practitioners who contributed to the ECQI dataset from the following institutions. In Belarus: the NN Alexandrov National Cancer Centre of Belarus; in Denmark: Herlev Hospital, Kirurgisk Klinik Frederikssund, Kirurgisk Klinik Syddanmark, Odense University Hospital Svendborg Sygehus; in Finland: Tampere University Hospital; in Germany: Allgemeines Krankenhaus Celle AKH, Gemeinschaftspraxis für Gastroenter-ologie und Innere Medizin Aschaffenburg, Internisten am Dominikanerplatz Würzburg, Klinikum Aschaffen-burg-Alzenau, Mathias-Spital Rheine, Sankt Elisabeth Hospital Gütersloh; in Hungary: Markusovszky University Teaching Hospital, University of Pécs, University of Szeged; in Italy: Centro di Riferimento Oncologico IRCCS, CTO and Sirai Hospitals Sardinia, Fondazione Poliambulanza Brescia, Fondazione Policlinico Gemelli Rome, Policlinico Umberto I “Sapienza” University of Rome; in Portugal: Centro Hospitalar do Baixo Vouga Aveiro, Centro Hospitalar Tondela-Viseu, Centro Hospitalar e Universitário de Coimbra, Endocentro—Idealmed UHC Coimbra, Portuguese Oncology Institute Coimbra, ULS Guarda; in Romania: Gastroenterology and Hepatology Center-TVM—Cluj-Napoca, Octavian Fodor Regional Institute of Gastroenterology and Hepatology, Research Center of Gastroenterology and Hepatology University of Medicine and Pharmacy of Cra-iova; in Russia: Yaroslavl Regional Cancer Hospital; in Spain: Hospital Á lvaro Cunqueiro Vigo, Hospital Clínico Universitario Virgen de la Arrixaca, Hospital General Universitario de Alicante, Hospital del Mar Barcelona, Hospital Nisa Sevilla Aljarafe, Hospital Universitario de Fuenlabrada, Hospital Universitario Central de Asturias, Hospital Universitari i Politècnic La Fe Valencia; in Sweden: Ä ngelholm Hospital, Blekinge Hospital Karlshamn-Karlskrona, Capio St Göran’s Hospital Stockholm, Central Hospital Karlstad, Centralsjukhuset Kristianstad, GHP Stockholm Gastro Center, Helsingborg Hospital, Institute of Medicine Huddinge Karolinska Hospital Stockholm, Karolin-ska University Hospital Stockholm, Skåne University Hospital Malmö, South Ä lvsborg Hospital Borås, Specialistläkarna i Lund, Sunderby Hospital Luleå, University Hospital Linköping, Ystad Hospital; in the United Kingdom: Barnsley District General Hospital, Doncaster Royal Infirmary, Mid Yorkshire NHS Trust Grange Medical Centre, Royal Liverpool and Broadgreen University Hospitals, The Royal Infirmary of Edinburgh. Conflicts of Interest: C.S. is a consultant and advisory board participant for Norgine, AlfaSigma, Medtronic, Given Imaging, Covidien, Olympus, IntroMedic, AnX Robotica. A.K. reports material support from IntroMedic/SynMedUK, Jinshan/Aquilant; honoraria from Ferring UK, Dr Falk Pharma UK; travel support from Norgine, Jinshan/Aquilant; advisory board Dr Falk Pharma UK, Tillots; Given® Imaging Ltd. / ESGE research grant 2011; cofounder AJM Med-i-caps Ltd, director of iCERV LTD and consultant for Jinshan (since March 2021). P.A. reports consultancy and advisory board participant for Norgine. L.B. reports consultancy & advisory board participant AMBU; travel support from Norgine. W.F. reports consultancy and advisory board participant to Norgine; speaking—Abbott, Bio Merieux, Falk; advisory speaking—Aptalis, Fresenius Biotech, Pfizer; advisory— Boehringer Ingelheim, med update. M.H. reports travel support from Norgine. R.J. reports consultancy—Norgine, MSD, GI Supply, CPP Pharma. U.K. reports travel support from Norgine. A.O. reports travel support from Norgine. E. T. reports consultancy and advisory board participant for Norgine. A.A., Á .P., S.P., L.P., J.F.R., L.F., G.A. & C.H. declare that they have no conflict of interest. H.S. received fees for statistical services and A.L.S. received fees for manuscript preparation from the ECQI Secretariat. The funder does not have direct access to the data. The funder had limited input into the design of the survey. The funder had no role in the collection, analyses, or interpretation of data, in the writing of the manuscript, or in the decision to publish the results.
Keywords
- Colonoscopy
- Colonoscopy standards
- Quality measures
- Withdrawal time
Publication forum classification
- Publication forum level 1
ASJC Scopus subject areas
- Clinical Biochemistry