ASGE Masterclass: Colonoscopy (On-Demand) | January 2022-An Update on Quality Indicators of Colonoscopy, Surveillance Guidelines and Bowel Prep

Video Transcription

Video Summary

In this video, Dr. Asma Chakrata provides an update on quality indicators for colonoscopy surveillance guidelines and bowel prep. She begins by discussing the importance of quality in colonoscopy, highlighting its effectiveness in detecting and preventing colon cancer, reducing missed or interval cancers, ensuring safety and reducing complications, being tied to reimbursement through MIPS and APM programs, and satisfying patient demands. Dr. Chakrata then explains the quality metrics outlined in the ASGE practice guideline, which include pre-procedural, intra-procedure, and post-procedure indicators. She specifically focuses on bowel prep quality and surveillance interval recommendations. Inadequate bowel prep can lead to delays in diagnosis, wasted resources, and repeat procedures, and she discusses various FDA-approved and non-FDA-approved regimens. Dr. Chakrata emphasizes the importance of split-dose prep, as it has been shown to increase prep adequacy and improve adenoma detection rate. She also discusses the use of a low-residue diet and other strategies to improve tolerability and patient adherence. Regarding surveillance intervals, she explains that recent guidelines have extended the recommendation for individuals with low-risk adenomas to 7-10 years instead of 3 or 5 years, based on evidence that their risk of colon cancer is similar to that of individuals with normal colonoscopies. She also mentions changes in the surveillance intervals for individuals with 3-4 adenomas and serrated polyps. Dr. Chakrata highlights the use of report cards and personalized regimens to measure and improve quality, and concludes by emphasizing the importance of surveillance colonoscopy in appropriate individuals as a high-value care.

Asset Subtitle

Aasma Shaukat, MD, MPH, FASGE

Keywords

colonoscopy surveillance guidelines

quality indicators

bowel prep

ASGE practice guideline

adequate bowel prep

surveillance intervals