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CC BY-NC-ND 4.0 · Endosc Int Open 2021; 09(10): E1456-E1462
DOI: 10.1055/a-1486-6729
Original article

Colonoscopy quality across Europe: a report of the European Colonoscopy Quality Investigation (ECQI) Group

Cristiano Spada
 1   Digestive Endoscopy Unit and Gastroenterology, Fondazione Poliambulanza, Brescia, Italy
 2   Digestive Endoscopy Unit, Università Cattolica del Sacro Cuore, Rome, Italy
,
Anastasios Koulaouzidis 
 3   Pomeranian Medical University in Szczecin-Department of Social Medicine and Public Health, Faculty of Health Sciences, Szczecin, Zachodniopomorskie, Poland
,
Cesare Hassan 
 4   Digestive Endoscopy, Nuovo Regina Margherita Hospital, Rome, Italy
,
Pedro Amaro
 5   Gastroenterology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
,
Anurag Agrawal
 6   Doncaster Royal Infirmary, Doncaster, UK
,
Lene Brink
 7   Herlev and Gentofte Hospital, Copenhagen University, Gastro Unit, Division of Endoscopy, Herlev, Denmark
,
Wolfgang Fischbach
 8   Gastroenterologie und Innere Medizin, Aschaffenburg, Germany
,
Matthias Hünger
 9   Private Practice for Internal Medicine, Würzburg, Germany
,
Rodrigo Jover
10   Hospital General Universitario de Alicante – Instituto de Investigación Sanitaria ISABIAL – Servicio de Medicina Digestiva, Alicante, Spain
,
Urpo Kinnunen
11   Tampere University Hospital-Gastroenterology, Tampere, Finland
,
Akiko Ono
12   Hospital Clínico Universitario Virgen de la Arrixaca-Gastroenterology, El Palmar, Murcia, Spain
,
Árpad Patai
13   Markusovszky University Teaching Hospital-Gastroenterology, Szombathely, Hungary
,
Silvia Pecere 
14   Digestive Endoscopy Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
,
Lucio Petruzziello
14   Digestive Endoscopy Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
,
Jürgen F. Riemann
15   LebensBlicke Foundation, Ludwigshafen, Germany
,
Bharat Amlani
16   Norgine Ltd-Medical Affairs, Harefield, UK
,
Harry Staines
17   Sigma Statistical Services Ltd, Saint Andrews, UK
,
Ann L. Stringer
18   ECQI Secretariat, Buckinghamshire, UK
,
Ervin Toth 
19   Skåne University Hospital, Lund University, Department of Gastroenterology, Malmö, Sweden
,
Giulio Antonelli
 4   Digestive Endoscopy, Nuovo Regina Margherita Hospital, Rome, Italy
20   Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, “Sapienza” University of Rome, Rome, Italy
21   Gastroenterology and Digestive Endoscopy Unit, Ospedale dei Castelli Hospital, Ariccia, Rome, Italy
,
Lorenzo Fuccio
22   Gastroenterology Unit, Department of Medical and Surgical Sciences, S. Orsola-Malpighi Hospital, Bologna, Italy
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ESGE quality parameters in colonoscopy: How to ensure their adoption?Endosc Int Open 2021; 09(10): E1463-E1465
DOI: 10.1055/a-1486-6788

Abstract

Background and study aims The European Colonoscopy Quality Investigation (ECQI) Group comprises expert colonoscopists and investigators with the aim of raising colonoscopy standards. We assessed the levels of monitoring and achievement of European Society of Gastrointestinal Endoscopy (ESGE) performance measures (PMs) across Europe using responses to the ECQI questionnaires.

Methods The questionnaire comprises three forms: institution and practitioner questionnaires are completed once; a procedure questionnaire is completed on multiple occasions for individual total colonoscopies. ESGE PMs were approximated as closely as possible from the data collected via the procedure questionnaire. Procedure data could provide rate of adequate bowel preparation, cecal intubation rate (CIR), withdrawal time, polyp detection rate (PDR), and tattooing resection sites.

Results We evaluated ECQI questionnaire data collected between June 2016 and April 2018, comprising 91 practitioner and 52 institution questionnaires. A total of 6445 completed procedure forms were received.

Institution and practitioner responses indicate that routine recording of PMs is not widespread: adenoma detection rate (ADR) is routinely recorded in 29 % of institutions and by 34 % of practitioners; PDR by 42 % and 47 %, CIR by 62 % and 64 %, bowel preparation quality by 56 % and 76 %, respectively.

Procedure data showed a rate of adequate bowel preparation of 84.2 %, CIR 73.4 %, PDR 40.5 %, mean withdrawal time 7.8 minutes and 12.2 % of procedures with possible removal of a non-pedunculated lesion ≥ 20 mm reporting tattooing.

Conclusions Our findings clearly show areas in need of quality improvement and the importance of promoting quality monitoring throughout the colonoscopy procedure.

Supplementary material



Publication History

Received: 15 October 2020

Accepted: 10 March 2021

Article published online:
16 September 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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