The researchers set out to assess the variability of the two quality indicators over time. The study included 80,056 colonoscopies performed by 51 board-certified gastroenterologists. The results included:
• ADRs from 13 to 45 percent
• Withdrawal times from 3.5 to 14 minutes
• ADR net change from -2 to +28 percent
• Withdrawal net change from -0.5 to +three minutes
The researchers found the ADR and withdrawal time improved over time in response to interventions. They also observed the two quality indicators, though not linearly related, are closely associated.
Interventions to improve the quality indicators include:
• Education
• Blinded and unblinded informal feedback
• Sharing peers’ quality data
• Establishment of benchmarks tied to financial incentives and penalties
• Changes in bowel preparation
• Adoption of new technology
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