Development of Quality Indicators and Quality Improvement Plan of Colonoscopy in Experienced Endoscopist

Study Overview
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Brief Summary
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The purpose of this study is to determine clinical factors affecting quality indicators of colonoscopy including adenoma detection rate, and whether quality of colonoscopy could be elevated by improving related factors.

Detailed Description
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This study is an extension of quality assurance program in Seoul National University Hospital Healthcare System Gangnam Center. This study is composed of five periods. First, quality indicators of colonoscopy in experienced endoscopists will be analyzed retrospectively from January 2011 to december 2014. Individual differences and changes of quality indicators in every endoscopist will be verified. In second period, from January 2015 to March 2015, quality assurance program will be activated. Endoscopists will be educated by EQUIP (Endoscopic Quality Improvement Program). Also split-regimen bowel preparation instead of same-day regimen and Boston bowel preparation scale will be introduced to standardize disparity of grading. Third, prospective trial starts from April 2015 to March 2018. All endoscopists will receive feedbacks of their own adenoma detection rates in every 3 months. Changes of quality indicators for each endoscopist will be investigated, and annually monitored by institutional review board. If there is a significant improvement of quality indicators in interim assessment, prospective trial will be extended until April 2018. Fourth is wash-out period from April 2018 to march 2019. Feedbacks will be stopped and adenoma detection rates and quality indicators of endoscopists will be compared with those from prospective period. Finally, cumulative rate and mortality rate of colorectal cancers will be investigated until December 2019.

Official Title
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Seoul National University Hospital Healthcare System Gangnam Center Colonoscopy Quality Upgrade Project (Gangnam-CUP): Development of Quality Indicators and Quality Improvement Plan of Colonoscopy in Experienced Endoscopist.

Conditions
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Colonic Polyps, Colonic Neoplasms

Intervention / Treatment
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* Behavioral: Feedback


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Customers who received colonoscopy in Seoul National University Hospital Healthcare System Gangnam Center from 2011 to 2019. Exclusion Criteria: Age <18 years Customers who refused to offer their health check up data History of inflammatory bowel disease History of familial adenomatous polyposis Customers who received Incomplete colonoscopy History of previous colorectal resection

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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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experienced endoscopists<br>All of the experienced endoscopists will receive feedbacks from investigators about their own adenoma detection rate every 3 months | Behavioral: Feedback<br>* Experienced endoscopists will receive feedbacks from investigators about their own adenoma detection rates.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Adenoma detection rate | (total, right, transverse, left) | 8 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Colonoscopy performance indicators | Colonoscopy withdrawal time in negative complete colonoscopy | 8 years | 
| Colonoscopy performance indicators | The number of taken pictures in negative complete colonoscopy | 8 years | 
| Colonoscopy performance indicators | The position changes during colonoscope insertion and withdrawal | 8 years | 
| Colonoscopy quality indicators | Colorectal cancer detection rate | 8 years | 
| Colonoscopy quality indicators | Advanced adenoma detection rate | 8 years | 
| Colonoscopy quality indicators | Adenoma detection rate plus | 8 years | 
| Colonoscopy quality indicators | Polyp detection rate (total, right, transverse, left) | 8 years | 
| Colonoscopy quality indicators | Multiple adenoma detection rate | 8 years | 
| Colonoscopy quality indicators | Serrated polyp detection rate (total, right, transverse, left) | 8 years | 
| Colonoscopy quality indicators | Complication rate (bleeding, perforation, pain) | 8 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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colonoscopy, quality improvement, adenoma detection rate