ChesterCountyMedicineWinter2018 - 2

What  is  a  Quality  Colonoscopy?  
Not	
  all	
  colonoscopies	
  are	
  alike!	
  	
  Studies	
  show	
  a	
  marked	
  difference	
  in	
  colorectal	
  cancer	
  (CRC)	
  
risk	
  reduction	
  between	
  facilities	
  and	
  physicians	
  	
  
What  are  the  most  important  factors  for  a  high  quality  colonoscopy?  *ASGE  guidelines  
	
  
 Cecal  intubation  rate  with  photo  documentation,	
  i.e.	
  How	
  often	
  do	
  we	
  make	
  it	
  to	
  the	
  end?	
  
o Benchmark:	
  >90%	
  
o West	
  Chester	
  Gastrointestinal	
  Group	
  (WCGG):	
  99%	
  
 Proper  use  of  recommended  intervals	
  between	
  colonoscopies	
  performed	
  for	
  average--‐risk	
  patients	
  and	
  
for	
  colon	
  polyp	
  surveillance.	
    
o WCGG	
  has	
  a	
  robust,	
  blinded,	
  quarterly	
  evaluation	
  of	
  representative	
  pathology	
  for	
  each	
  
physician	
  to	
  ensure	
  proper	
  surveillance.	
  	
  Our	
  CMS	
  QualityNet	
  Data	
  shows	
  compliance	
  in	
  excess	
  
of	
  98%.	
  
	
  
 Adenoma  Detection  Rate  or  ADR,  the  most  important  measure  of  a  quality  colonoscopy	
  	
  (i.e.	
  how	
  
often	
  do	
  we	
  detect	
  a	
  pre--‐cancerous	
  polyp	
  in	
  the	
  colon	
  and	
  remove	
  it?)	
  
o Benchmark	
  by	
  ASGE/AGA:	
  ADR	
  target	
  of	
  30%	
  is	
  recommended	
  for	
  men	
  and	
  20%	
  for	
  women.	
  
	
  	
  
	
  
	
  
	
  
	
  
	
  
	
  
	
  
	
  Source:	
  GIQuIC,	
  a	
  CMS	
  approved	
  Qualified	
  Clinical	
  Data	
  Registry	
  (QCDR)	
  
	
  
	
  

For  every  1%  increase  in  ADR,  
there  was  a  3%  reduction  in  
CRC  incidence  and  5%  
reduction  in  cancer  mortality.      
Higher  ADRs  were  associated  
with  lower  risk  of  cancer  in  
both  men  and  women.	
  	
  	
  
Corley,  D  et  al,  Adenoma  Detection  Rate  and  
Risk  of  Colorectal  Cancer  and  Death,  NEJM,  
2014;  370:1298--‐306.	
  

	
  

WEST  CHESTER      ● EXTON      ● KENNETT  SQUARE      ● WEST  GROVE	
  	
  	
  	
  	
  	
  www.westchestergi.com	
  	
  	
  	
  (610)  431--‐3122
http://www.westchestergi.com
ChesterCountyMedicineWinter2018

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