P45 Time to move onto chromoendoscopy as standard?

Abstract

Results An average of 2460±366 colonoscopies were performed in every 6-month period by 42±4 endoscopists. Collective ADR and PDR were 12% and 19%, respectively, at the beginning of the study period. Figure 1 shows a continuous improving trend in collective performance was recorded since the provision of individual feedback started. Departmental ADR improved from the initial 12% to 22% (Slope .10 ±.01; R 2 .84, p<0.0001), and PDR from 19% to 30% (Slope .10±.01; R 2 .78, p<0.0001) in the last 6-month period. Interestingly, the ADR/PDR ratio (overall 0.68±0.05, mean±SD) also increased over time from a baseline of 0.63 to a final figure of 0.73 (Slope .001±.0003; R 2 .52, p<0.01). Other KPIs showed similar improving trends. The number of non-neoplastic polyps detected did not increase during the study period. Conclusions Our data show that regular written feedback to endoscopists about their individual and departmental KPIs, along with expected benchmarks, improves adenoma detection and overall endoscopy performance. The parallel improvement of ADR/PDR ratio suggests that the above result is not due to increased removal of no-risk polyps, which is a potential unintended consequence of PDR monitoring. Concomitant monitoring of ADR and PDR may be important to prevent 'gaming' behaviour and ensure that a genuine quality improvement is achieved.