A Trial of an Audit and Feedback Report to Improve Colonoscopy Performance

Study Overview
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Brief Summary
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This project aims to measure the impact of a physician report card (also called an audit & feedback report) on colonoscopy performance. Endoscopists in Ontario will be randomly assigned to either receive the endoscopist report card or to no feedback. Using Ontario health administrative data, the quality of colonoscopy will be compared between those who received the report card and those who do not. The investigators will also measure the effect of receiving endoscopist report card on colonoscopy performance amongst endoscopists who perform poorly at baseline compared to those who do not. Further, the acceptability of two educational interventions that aim to improve the quality of colonoscopy will be evaluated by conducting one-on-one interviews with select participants. This study is critical to ensure that Canadians have access to the highest quality colonoscopy possible.

Official Title
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A Randomized Controlled Trial of an Audit and Feedback Report to Improve Colonoscopy Performance

Conditions
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Colorectal Polyps

Intervention / Treatment
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* Other: Individualized A/F report
* Other: A/F report plus a high intensity intervention
* Other: A/F report plus a low intensity intervention
* Other: A/F report alone


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All practising endoscopists in Ontario who performed at least 5 colonoscopies in 2014 Exclusion Criteria: -

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 |
| --- | --- |
| Experimental: Round 1: Intervention arm<br>Half of the endoscopists in Ontario will receive an individualized audit & feedback report. Individualized A/F report. | Other: Individualized A/F report<br>* Individualized A/F report containing 9 colonoscopy quality measures.<br>|
| No Intervention: Round 1: Control<br>Half of the endoscopists in Ontario will NOT receive an individualized audit & feedback report. | |
| Other: Round 2: Month 12<br>All endoscopists in Ontario will receive an individualized audit & feedback report at month 12. Individualized A/F report | Other: Individualized A/F report<br>* Individualized A/F report containing 9 colonoscopy quality measures.<br>|
| Other: Round 2: Poor performers<br>In Round 2, selected 60 poorer performers will be randomly assigned to receive one of the following interventions at month 12: A/F report plus a high intensity intervention A/F report plus a low intensity intervention A/F report alone | Other: A/F report plus a high intensity intervention<br>* E.g. Master class in colonoscopy<br>Other: A/F report plus a low intensity intervention<br>* E.g. Access to a video/presentation on good colonoscopy technique followed by a post presentation assessment.<br>Other: A/F report alone<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in polypectomy rate from baseline | Measure change in polypectomy rate from baseline | At month 12 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Additional outcome 1- Change in cecal intubation rate | Change in cecal intubation rate from baseline | At month 12 | 
| Additional outcome 2 - Change in annual colonoscopy volume | Change in annual colonoscopy volume from baseline | At month 12 | 
| Additional outcome 3 - Change in poor bowel preparation rate | Change in poor bowel preparation rate from baseline | At month 12 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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endoscopy measures, audit and feedback, quality improvement, randomized controlled trial, Colonoscopy