Updated Colonoscopy Quality Indicators: What They Mean for Your Practice | September 2024-ASGE ACG quality indicators for colonoscopy 2024

ASGE ACG quality indicators for colonoscopy 2024

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This document outlines quality indicators for gastrointestinal (GI) endoscopic procedures, specifically targeting colonoscopy, which is key in colorectal cancer (CRC) prevention. In the US, colonoscopy is widely used for primary CRC screening, diagnosis in symptomatic patients, post-resection surveillance, genetic predispositions, and monitoring of inflammatory bowel diseases like ulcerative colitis (UC) and Crohn’s disease.<br /><br />Evidence supports colonoscopy in reducing CRC incidence and mortality, especially for left-sided colon cancers. Accurate results significantly rely on the operator's skill, highlighting a need for standardized high-quality performance practices. Quality measurement has emerged over the past 20 years to enhance colonoscopy consistency, guided by recommendations from the American Society for Gastrointestinal Endoscopy (ASGE) and the American College of Gastroenterology (ACG).<br /><br />Critical performance aspects for high-quality colonoscopy include adequate bowel prep, complete colonoscope insertion, thorough lesion examination, full and curative lesion resection, and precise documentation. Performance in these areas is detected through indicators, categorized into preprocedure, intraprocedure, and postprocedure measures. Outcomes depend on correlating quality practices with benchmark results for consistency and reliability.<br /><br />Priority indicators, essential for any endoscopic unit, are delineated based on clinical significance, variable performance, and measurement feasibility. These include:<br /><br />- Adenoma Detection Rate (ADR)<br />- Detection Rate for Sessile Serrated Lesions (SSLs)<br />- Recommended Screening and Surveillance Intervals Usage<br />- Adequate Bowel Preparation Rate<br />- Cecal Intubation Rate (CIR)<br /><br />Indicators also exist specifically for inflammatory bowel disease (IBD). Methodologically, literature review and expert consensus aid in forming these guidelines, emphasizing preprocedure appropriateness, detailed documentation, and effective postprocedure follow-up.<br /><br />Lastly, adverse events post-colonoscopy like perforation and bleeding, although rare, are critical to monitor. Adapting a systematic review and improvement approach ensures better patient outcomes and procedural safety, reinforcing the necessity of high-quality, standardized practices across colonoscopy procedures to optimize CRC prevention.

Keywords

colonoscopy

colorectal cancer

CRC prevention

quality indicators

adenoma detection rate

inflammatory bowel disease

bowel preparation

Cecal Intubation Rate

American Society for Gastrointestinal Endoscopy

American College of Gastroenterology