Endoscopic Quality Improvement Program

Study Overview
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Brief Summary
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Effective colorectal cancer (CRC) screening relies on early identification and removal of both polypoid and non-polypoid lesions with neoplastic potential. The investigators hypothesize that an intensive training program designed to enhance both recognition and classification of lesions with neoplastic potential, will result in an increase in non-polypoid adenoma detection in addition to and independent of an increase in overall adenoma detection rates.

Detailed Description
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Our Endoscopic Quality Improvement Program (EQUIP) was a prospective educational intervention with our staff endoscopist as our study population. The investigators measured adenoma detection rates for a baseline period then randomly assigned half of the endoscopists to undergo EQUIP training. The investigators then examined baseline and post-training study adenoma detection rates (ADR's) for all endoscopist (trained and un-trained) to evaluate the impact of training.

Official Title
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The Effect of an Intensive Endoscopic Quality Improvement Program (EQUIP) on Improved Detection and Classification of Non-polypoid (Flat and Depressed) and Polypoid Colorectal Adenomas. (EQUIP Study)

Conditions
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Adenomatous Polyps, Colorectal Polyps

Intervention / Treatment
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* Other: Training session


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Colonoscopies performed at Mayo clinic ambulatory surgical center Exclusion Criteria: Procedures for the indication of acute GI hemorrhage Active colitis Hereditary polyposis syndrome Inflammatory bowel disease Incomplete procedures Procedures with surgically altered anatomy (i.e. prior colectomy) Poor bowel preparation (Boston Bowel preparation score <5) were also excluded.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Baseline Data collection<br> | |
| Experimental: Randomization and Training Arm<br> | Other: Training session<br>* Series of two training sessions after the first phase of study followed by monthly feedback.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Measurement of overall adenoma detection rate | Primary outcome measures will include overall and per patient adenoma detection rate for polypoid and non polypoid neoplastic lesions. | 1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Measurement of total polypectomy rate | Secondary outcomes will include total polypectomy rate (hyperplastic vs. adenoma), | 1 Year | 
| Measurement of colonoscopy time | Total colonoscopy time and endoscopist acceptance. Variables such as patient demographics and prep quality will be adjusted for. | 1 Year | 
| Endoscopist Acceptance | Ensdoscopist acceptance rate will be measured. Variables such as patient demographics and prep quality will be adjusted for. | 1 Year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Quality Improvement, Adenoma Detection Rate, Polyp detection rate, Colonoscopy, Training, Colorectal cancer screening