Nationally Automated Colonoscopy Performance Feedback Increases Polyp Detection: The National Endoscopy Database – Automated Performance Reports to Improve Quality Outcomes Trial (NED-APRIQOT) a Cluster Randomised Controlled Trial.
Catlow, Jamie, Sharp, Linda, Wagnild, Janelle, Lu, Liya, Bhardwaj-Gosling, Rashmi, Ogundimu, Emmanuel, Adetayo, Kasim, Brookes, Matthew, Thomas, Lee, McCarthy, Stephen, Gray, Joanne, Sniehotta, Falko, Valori, Roland, Westwood, Claire, McNally, Richard, Ruwende, Josephine, Sinclair, Simon, Deane, Jill and Rutter, Matt (2024) Nationally Automated Colonoscopy Performance Feedback Increases Polyp Detection: The National Endoscopy Database – Automated Performance Reports to Improve Quality Outcomes Trial (NED-APRIQOT) a Cluster Randomised Controlled Trial. Clinical Gastroenterology and Hepatology. ISSN 1542-3565 (In Press)
Item Type: | Article |
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Abstract
Background and Aims
Post-colonoscopy colorectal cancer incidence and mortality rates are higher for endoscopists with low polyp detection rates. Using the UK’s National Endoscopy Database (NED), which automatically captures real-time data, we assessed if providing feedback of case-mix-adjusted Mean Number of Polyps (aMNP), as a key performance indicator, improved endoscopists’ performance. Feedback was delivered via a theory-informed evidence-based audit and feedback intervention.
Methods
This multicentre, prospective, NED Automated Performance Reports to Improve Quality Outcomes Trial (NED-APRIQOT) randomised NHS endoscopy centres to intervention or control. Intervention-arm endoscopists were emailed tailored monthly reports automatically generated within NED, informed by qualitative interviews and behaviour change theory. The primary outcome was endoscopists’ aMNP during the 9-month intervention.
Results
From November 2020-July 2021, 541 endoscopists across 36 centres (19 intervention; 17 control) performed 54,770 procedures during the intervention, and 15,960 procedures during the 3-months post-intervention period. Comparing intervention-arm to control-arm endoscopists during the intervention period: aMNP was non-significantly higher (7%, 95% confidence interval (CI) -1% to 14%; p=0·08). Unadjusted MNP (10%, 95%CI 1-20%) and polyp detection rate (PDR) (10%, 95%CI 4-16%) were significantly higher. Differences were not maintained in the post-intervention period. In the intervention-arm, endoscopists accessing NED-APRIQOT webpages had higher aMNP than those who did not (118 vs 102 aMNP, p=0.03).
Conclusion
Although our automated feedback intervention did not increase aMNP significantly in the intervention period; MNP and PDR did significantly improve. Engaged endoscopists benefited most and improvements were not maintained post-intervention; future work should address engagement in feedback and consider the effectiveness of continuous feedback.
www.isrctn.org ISRCTN11126923
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More Information
Uncontrolled Keywords: Endoscopy Quality improvement Audit and feedback Detection |
Depositing User: Rashmi Bhardwaj-Gosling |
Identifiers
Item ID: 17362 |
ISSN: 1542-3565 |
URI: http://sure.sunderland.ac.uk/id/eprint/17362 |
Users with ORCIDS
Catalogue record
Date Deposited: 27 Feb 2024 11:11 |
Last Modified: 08 Oct 2024 09:30 |
Author: | Rashmi Bhardwaj-Gosling |
Author: | Jamie Catlow |
Author: | Linda Sharp |
Author: | Janelle Wagnild |
Author: | Liya Lu |
Author: | Emmanuel Ogundimu |
Author: | Kasim Adetayo |
Author: | Matthew Brookes |
Author: | Lee Thomas |
Author: | Stephen McCarthy |
Author: | Joanne Gray |
Author: | Falko Sniehotta |
Author: | Roland Valori |
Author: | Claire Westwood |
Author: | Richard McNally |
Author: | Josephine Ruwende |
Author: | Simon Sinclair |
Author: | Jill Deane |
Author: | Matt Rutter |
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