Institutional Review Boards at the MDHMH and the University of Maryland exempted this study. LHDs receive the provider’s routine colonoscopy reports and enter results into a secure intranet-based database maintained at the Maryland Department of Health and Mental Hygiene (MDHMH) for local case management, program statistics, and quality assurance. Most of those jurisdictions accepted patients with lower-gastrointestinal symptoms such as abdominal pain, constipation, and blood in stool. Eighty-one percent (81%) of the targeted population in Maryland resided in these 22 jurisdictions. Under this program, in 20, 22 of 24 local health departments (LHDs) offered CRC screening targeted to Maryland residents who were 50–64 years old, with low income, and uninsured. We selected colonoscopy reports for review from a database containing information related to colonoscopies performed through Maryland’s Cigarette Restitution Fund Colorectal Cancer Screening Program. This paper may provide baseline data to assess if CO-RADS has an impact on reporting and how best to improve the quality of reporting. The aim of this paper was to assess the quality of colonoscopy reports and determine if endoscopists in practice were already documenting recommended quality indicators, prior to the publication of CO-RADS. examined colonoscopy reports from the 73 Clinical Outcomes Research Initiative gastroenterology practice sites in the United States that used a structured, computerized endoscopy report generator. To our knowledge, only a few studies have directly evaluated colonoscopy reporting. Similar standardized reporting and data systems are in place for both Pap tests (the Bethesda System) and mammography. Standardized language also facilitates communication between the endoscopist and the primary care provider, who is often responsible for referring the patient for the next surveillance or screening colonoscopy. CO-RADS describes the specific elements for inclusion in all colonoscopy reports, recommends standard terms for procedure reporting, and suggests key quality indicators. To facilitate such quality measurement within and across practices, the Quality Assurance Task Group of the National Colorectal Cancer Roundtable (NCCRT) developed, and in 2007 published, a standardized Colonoscopy Reporting and Data System (CO-RADS). Measurement of quality indicators for colonoscopy reporting can identify areas for quality improvement. Appropriate documentation of the colonoscopy procedure is an important component of patient care and a key approach to measure health care quality. In order to measure indicators of quality, guidelines for reporting the indicators need to be in place.Ĭolonoscopy reporting practices are widely variable. In 2002, the MSTF-CRC published recommendations to improve the quality and effectiveness of colonoscopy and highlighted key indicators for continuous quality improvement (CQI). Many clinical practice studies have found variations in colonoscopy quality which has become a concern in the gastroenterology community. These include adequate visualization of the entire colon, diligence in examining the mucosa, and patient acceptance of the procedure. The effectiveness of colonoscopy in reducing CRC incidence and mortality depends on many factors. In the last few years, utilization of colonoscopy for CRC screening has increased dramatically. Any positive CRC screening test leads to a colonoscopy, which itself can be a primary CRC screening tool. Major national organizations such as the United States Preventive Services Task Force (USPSTF), the American Cancer Society, and the Multi-Society Task Force on Colorectal Cancer (MSTF-CRC) recommend that average-risk adults begin CRC screening at age 50. IntroductionĬolorectal cancer (CRC) screening reduces CRC incidence and mortality. This paper provides baseline data to assess if CO-RADS has an impact on reporting and how best to improve the quality of reporting. The absence of key data elements may impact the ability to make recommendations for recall intervals. Colonoscopy reporting varied considerately in the pre-CO-RADS period. For the 177 individual polyps identified, information on size and morphology was documented for 87% and 53%, respectively. Among 110 reports, 73% documented the bowel preparation quality and 82% documented specific cecal landmarks. We evaluated 25 key data elements recommended by CO-RADS, including procedure indications, risk/comorbidity assessments, procedure technical descriptions, colonoscopy findings, specimen retrieval/pathology. We examined 110 colonoscopy reports from 2005-2006 through Maryland Colorectal Cancer Screening Program. This paper aimed to assess quality of colonoscopy reports and determine if physicians in practice were already documenting recommended quality indicators, prior to the publication of a standardized Colonoscopy Reporting and Data System (CO-RADS) in 2007.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |