Close menu

SURE

Sunderland Repository records the research produced by the University of Sunderland including practice-based research and theses.

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

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

[img] PDF
NED APRIQOT RCT CGH Resubmission February 2024.pdf - Accepted Version
Restricted to Repository staff only until 3 February 2025.

Download (511kB) | Request a copy
[img]
Preview
PDF
1-s2.0-S154235652400449X-main.pdf
Available under License Creative Commons Attribution Non-commercial No Derivatives.

Download (862kB) | Preview

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

ORCID for Rashmi Bhardwaj-Gosling: ORCID iD orcid.org/0000-0002-1895-9899

Catalogue record

Date Deposited: 27 Feb 2024 11:11
Last Modified: 08 Oct 2024 09:30

Contributors

Author: Rashmi Bhardwaj-Gosling ORCID iD
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

University Divisions

Faculty of Health Sciences and Wellbeing > School of Nursing and Health Sciences

Subjects

Sciences > Health Sciences

Actions (login required)

View Item (Repository Staff Only) View Item (Repository Staff Only)