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

Video Transcription

Video Summary

In this video, Dr. Asma Ali discusses quality indicators for colonoscopy and provides updates on colonoscopy surveillance guidelines and bowel prep. The speaker emphasizes the importance of quality in colonoscopy by highlighting four parameters: effectiveness in detecting and preventing colon cancer, safety in reducing complications, reimbursement tied to quality through programs like MIPS and APM, and patient satisfaction. Dr. Ali explains that CMS has a website called Physician Compare where quality indicators are made publicly available for Medicare providers. She references the ASGE practice guideline that categorizes quality metrics into pre-procedural, intra-procedure, and post-procedure categories. She focuses on two specific metrics: bowel prep quality and surveillance interval recommendations. Inadequate bowel prep can lead to delayed diagnosis, wasted endoscopy slots, repeat procedures, and increased costs. Dr. Ali discusses various FDA-approved prep options, including split-dose prep, which has been shown to improve adequacy of prep and adenoma detection rate. She also mentions the importance of a low-residue diet and personalized regimens based on patient factors. With respect to surveillance intervals, Dr. Ali explains the recent changes in guidelines for low-risk adenomas and serrated polyps. For low-risk adenomas, the surveillance interval has been extended to 7-10 years for one to two small adenomas and 3-5 years for three to four adenomas. Serrated polyps have a recommended follow-up interval of 5-10 years. Dr. Ali concludes by emphasizing the importance of surveillance colonoscopy in appropriate individuals and the need to provide high-value care.

Asset Subtitle

Aasma Shaukat, MD, MPH, FASGE

Keywords

quality indicators

colonoscopy

colonoscopy surveillance guidelines

bowel prep

CMS Physician Compare

ASGE practice guideline