TY - JOUR
T1 - Recommendations for follow-up interval after colonoscopy with inadequate bowel preparation in a national colonoscopy quality registry
AU - Calderwood, Audrey H.
AU - Holub, Jennifer L.
AU - Greenwald, David A.
N1 - Funding Information:
DISCLOSURE: The following author received research support for this study from the National Cancer Institute (R21 CA227776), The Dartmouth-Hitchcock Cancer Research Fellows Program, the National Cancer Institute Cancer Center Support Grant (5P30CA023108) to the Dartmouth-Hitchcock Norris Cotton Cancer Center, and The Dartmouth Clinical and Translational Science Institute (award no. UL1TR001086) from the National Center for Advancing Translational Sciences of the National Institutes of Health: A. H. Calderwood. All other authors disclosed no financial relationships.
Publisher Copyright:
© 2022 American Society for Gastrointestinal Endoscopy
PY - 2022/2
Y1 - 2022/2
N2 - Background and Aims: Endoscopist recommendations regarding a repeat colonoscopy after inadequate bowel cleanliness have not been fully described. Our aim was to evaluate the timing of recommendations for repeat colonoscopy after inadequate bowel preparation using a large, national colonoscopy registry. Methods: We performed a cross-sectional analysis of all outpatient screening and surveillance colonoscopies among adults ages 50 to 75 reported in the GI Quality Improvement Consortium from 2011 to 2018. The primary outcome was a recommendation to repeat colonoscopy within 1 year. Secondary outcomes were recommendations based on indication of colonoscopy and colonoscopy findings and predictors of a recommendation to follow-up within 1 year. Results: There were 260,314 colonoscopies with inadequate bowel preparation performed at 672 different sites by 4001 endoscopists. Of these, 31.9% contained a recommendation for follow-up within 1 year. This did not differ meaningfully by examination indication. The severity of colonoscopy findings influenced the recommendations for follow-up (within 1 year in 84.0% of cases with adenocarcinoma, 51.8% with any advanced lesion, and 23.2% with 1-2 small adenomas). Younger age, more severe pathology, location in the Northeast, and performance by an endoscopist with an adenoma detection rate ≥25% were associated with recommendations for follow-up within 1 year. Conclusions: Only some colonoscopies with inadequate bowel preparation are recommended to be repeated within 1 year, which may have implications for potential missed lesions. Further understanding of reasons driving recommendations is an important next step to improving guideline-concordant colonoscopy practice.
AB - Background and Aims: Endoscopist recommendations regarding a repeat colonoscopy after inadequate bowel cleanliness have not been fully described. Our aim was to evaluate the timing of recommendations for repeat colonoscopy after inadequate bowel preparation using a large, national colonoscopy registry. Methods: We performed a cross-sectional analysis of all outpatient screening and surveillance colonoscopies among adults ages 50 to 75 reported in the GI Quality Improvement Consortium from 2011 to 2018. The primary outcome was a recommendation to repeat colonoscopy within 1 year. Secondary outcomes were recommendations based on indication of colonoscopy and colonoscopy findings and predictors of a recommendation to follow-up within 1 year. Results: There were 260,314 colonoscopies with inadequate bowel preparation performed at 672 different sites by 4001 endoscopists. Of these, 31.9% contained a recommendation for follow-up within 1 year. This did not differ meaningfully by examination indication. The severity of colonoscopy findings influenced the recommendations for follow-up (within 1 year in 84.0% of cases with adenocarcinoma, 51.8% with any advanced lesion, and 23.2% with 1-2 small adenomas). Younger age, more severe pathology, location in the Northeast, and performance by an endoscopist with an adenoma detection rate ≥25% were associated with recommendations for follow-up within 1 year. Conclusions: Only some colonoscopies with inadequate bowel preparation are recommended to be repeated within 1 year, which may have implications for potential missed lesions. Further understanding of reasons driving recommendations is an important next step to improving guideline-concordant colonoscopy practice.
UR - http://www.scopus.com/inward/record.url?scp=85118847558&partnerID=8YFLogxK
U2 - 10.1016/j.gie.2021.09.027
DO - 10.1016/j.gie.2021.09.027
M3 - Article
C2 - 34563501
AN - SCOPUS:85118847558
SN - 0016-5107
VL - 95
SP - 360-367.e2
JO - Gastrointestinal Endoscopy
JF - Gastrointestinal Endoscopy
IS - 2
ER -