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Variations in colonoscopy practice in Europe: A multicentre descriptive study (EPAGE)

Harris, Jennifer K; Vader, John-Paul; Wietlisbach, Vincent; Burnand, Bernard; Gonvers, Jean-Jacques; Froehlich, Florian; Benoni, Cecilia LU ; Toth, Ervin LU and , (2007) In Scandinavian Journal of Gastroenterology 42(1). p.126-134
Abstract
Objective. The volume of colonoscopies performed is increasing and differences in colonoscopy practice over time and between centres have been reported. Examination of current practice is important for benchmarking quality. The objective of this study was to examine variations in colonoscopy practice in endoscopy centres internationally. Material and methods. This observational study prospectively included consecutive patients referred for colonoscopy from 21 centres in 11 countries. Patient, procedure and centre characteristics were collected through questionnaires. Descriptive statistics were performed and the variation between centres while controlling for case-mix was examined. Results. A total of 6004 patients were included in the... (More)
Objective. The volume of colonoscopies performed is increasing and differences in colonoscopy practice over time and between centres have been reported. Examination of current practice is important for benchmarking quality. The objective of this study was to examine variations in colonoscopy practice in endoscopy centres internationally. Material and methods. This observational study prospectively included consecutive patients referred for colonoscopy from 21 centres in 11 countries. Patient, procedure and centre characteristics were collected through questionnaires. Descriptive statistics were performed and the variation between centres while controlling for case-mix was examined. Results. A total of 6004 patients were included in the study. Most colonoscopies (93%; range between centres 70-100%) were performed for diagnostic purposes. The proportion of main indications for colonoscopy showed wide variations between centres, the two most common indications, surveillance and haematochezia, ranging between 7-24% and 5-38%, respectively. High-quality cleansing occurred in 74% (range 51-94%) of patients, and 30% (range 0-100%) of patients received deep sedation. Three-quarters (range 0-100%) of the patients were monitored during colonoscopy, and one-quarter (range 14-35%) underwent polypectomy. Colonoscopy was complete in 89% (range 69-98%) of patients and the median total duration was 20 min (range of centre medians 15-30 min). The variation between centres was not reduced when case-mix was controlled for. Conclusions. This study documented wide variations in colonoscopy practice between centres. Controlling for case-mix did not remove these variations, indicating that centre and procedure characteristics play a role. Centres generally were within the existing guidelines, although there is still some work to be done to ensure that all centres attain the goal of providing high-quality colonoscopy. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Scandinavian Journal of Gastroenterology
volume
42
issue
1
pages
126 - 134
publisher
Taylor & Francis
external identifiers
  • scopus:33845958581
ISSN
1502-7708
DOI
10.1080/00365520600815647
language
English
LU publication?
yes
id
715def86-2566-4a08-90f4-51974eb4d446 (old id 592581)
date added to LUP
2008-08-08 12:51:29
date last changed
2017-01-01 08:05:34
@article{715def86-2566-4a08-90f4-51974eb4d446,
  abstract     = {Objective. The volume of colonoscopies performed is increasing and differences in colonoscopy practice over time and between centres have been reported. Examination of current practice is important for benchmarking quality. The objective of this study was to examine variations in colonoscopy practice in endoscopy centres internationally. Material and methods. This observational study prospectively included consecutive patients referred for colonoscopy from 21 centres in 11 countries. Patient, procedure and centre characteristics were collected through questionnaires. Descriptive statistics were performed and the variation between centres while controlling for case-mix was examined. Results. A total of 6004 patients were included in the study. Most colonoscopies (93%; range between centres 70-100%) were performed for diagnostic purposes. The proportion of main indications for colonoscopy showed wide variations between centres, the two most common indications, surveillance and haematochezia, ranging between 7-24% and 5-38%, respectively. High-quality cleansing occurred in 74% (range 51-94%) of patients, and 30% (range 0-100%) of patients received deep sedation. Three-quarters (range 0-100%) of the patients were monitored during colonoscopy, and one-quarter (range 14-35%) underwent polypectomy. Colonoscopy was complete in 89% (range 69-98%) of patients and the median total duration was 20 min (range of centre medians 15-30 min). The variation between centres was not reduced when case-mix was controlled for. Conclusions. This study documented wide variations in colonoscopy practice between centres. Controlling for case-mix did not remove these variations, indicating that centre and procedure characteristics play a role. Centres generally were within the existing guidelines, although there is still some work to be done to ensure that all centres attain the goal of providing high-quality colonoscopy.},
  author       = {Harris, Jennifer K and Vader, John-Paul and Wietlisbach, Vincent and Burnand, Bernard and Gonvers, Jean-Jacques and Froehlich, Florian and Benoni, Cecilia and Toth, Ervin and , },
  issn         = {1502-7708},
  language     = {eng},
  number       = {1},
  pages        = {126--134},
  publisher    = {Taylor & Francis},
  series       = {Scandinavian Journal of Gastroenterology},
  title        = {Variations in colonoscopy practice in Europe: A multicentre descriptive study (EPAGE)},
  url          = {http://dx.doi.org/10.1080/00365520600815647},
  volume       = {42},
  year         = {2007},
}