P1463 - Do Quality Metrics for Screening Colonoscopies Change Over the Year for Fellows-in-training?

Monday, October 25, 2021

10:30 AM – 4:15 PM PT

Location: Shoreline Exhibit Hall

Has Audio

Presenting Author(s)

Meredith Yellen, MD

University of Illinois at Chicago
Chicago, IL, United States

Meredith Yellen, MD¹, Jeffrey Rebhun, MD¹, Yinglin Xia, PhD², Asim Shuja, MD¹
¹University of Illinois at Chicago, Chicago, IL; ²University of Illinois at Chicago, Chicago,, IL

Introduction: - Annually, over 14 million colonoscopies are performed in the United States, thus, this skill is very important for a gastroenterology fellow to obtain during training. Studies suggesting a fellow must complete 275 colonoscopies to achieve competency.

- Several metrics have been introduced to assess quality of the procedure with adenoma detection rate (ADR) being the most well-studied. However, indicators such as polyp detection rate (PDR) have been shown to be inversely related to post-colonoscopy colorectal cancer (CRC).

The aim of this study is to assess the improvement in quality measures of screening colonoscopies during a fellow’s academic year

Methods: - A retrospective review of all adult patients who underwent screening outpatient colonoscopy with fellow involvement at a tertiary health center between January 2015-April 2020.

- We excluded patients with a history of CRC, colonic resection, procedures without fellow participation, and all diagnostic and surveillance procedures.

- ADR, PDR, and CWT were compared between colonoscopies performed.

Results: - 837 colonoscopies were included in our analysis

- An analysis of the academic year by quarter showed no significant difference in number of colonoscopies performed. Patient variables, such as age and sex were not significantly different in each quarter. Race, however, was found to be statistically significant.

- ADR, although lowest in the first quarter, did not statistically significantly vary during the four quarters: first quarter (42% + .04), second quarter (49% + .37), third quarter (50% + .03), fourth quarter (44% +.03 P= 0.29).

- PDR was statistically significant when comparing it among quarters with the first quarter (56% + .04), second quarter (68% + .03), third quarter (70% + .03), fourth quarter (60% + .03 P= 0.01).

- CWT was also statistically significant when comparing it among quarters with the first quarter (18% +.6), second quarter (17.7% + .67), third quarter (15% + .61), fourth quarter (14% + .50 P< .001).

Discussion: - Our results suggest that progression in training does not result in an increase in ADR when performed by both a fellow and supervising endoscopist. However, it appears several other quality indicators may be significantly lower in the first quarter of the year. PDR appears to significantly increase during the year, while CWT significantly decreases. Further studies are required to make definitive conclusions regarding quality metrics as a fellow’s year progresses.

	Jul-Sep	Oct-Dec	Jan-Mar	Apr-Jun	P-Value
Outcome	Mean Performance Outcome (SEM)
ADR	.42 (.04)	.49 (.37)	.50 (.03)	.44 (.03)	0.29
APC	.73 (.08)	1.02 (.10)	1.02 (.10)	.75 (.07)	0.02
PDR	.56 (.04)	.68 (.03)	.70 (.03)	.60 (.03)	0.01
RSP	.43 (.04)	.48 (.04)	.44 (.03)	.38 (03)	0.23
CWT	18.3 (.6)	17.7 (.67)	15.1 (.61)	14.1 (.50)	< .001

Table: Table 1: Quality metrics of colonoscopies during different quarters

Disclosures:
Meredith Yellen indicated no relevant financial relationships.
Jeffrey Rebhun indicated no relevant financial relationships.
Yinglin Xia indicated no relevant financial relationships.
Asim Shuja indicated no relevant financial relationships.

Meredith Yellen, MD¹, Jeffrey Rebhun, MD¹, Yinglin Xia, PhD², Asim Shuja, MD¹. P1463 - Do Quality Metrics for Screening Colonoscopies Change Over the Year for Fellows-in-training?, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.