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Oral 10 Effect of an Endoscopic Quality Improvement Program on Adenoma Detection Rates: A Multicenter Cluster-Randomized Controlled Trial in Clinical Practice Setting (EQUIP-3)
Author Insight from Michael Wallace, MD, MPH, Mayo Clinic
A Mayo Clinic study aimed at improving the quality of colonoscopy and the rate of polyp detection will receive an award October 19 at the annual meeting of the American College of Gastroenterology, being held in Hawaii.
The study, by researchers at the Florida campus of Mayo Clinic, proved that even large private practices that already demonstrated high quality colonoscopies can benefit from the quality improvement program, known as Endoscopic quality improvement program or EQUIP.
In the study, five practices received the EQUIP training and four did not, although all sites knew they were being monitored. “The sites that received the training had a highly significant improvement in their quality as measured by adenoma detection whereas the other sites had only a small, insignificant improvement,” says the study’s senior investigator, Michael Wallace, MD, MPH, a professor of medicine. Although the difference in gains between the groups was not significant, the study suggests that participation in a monitoring program alone was associated with higher quality. The American College of Gastroenterology and the American Society for Gastrointestinal Endoscopy now offer such a program called “GIQUIC,” which was also the one used in this study.
“Colonoscopy is the most effective method or preventing colorectal cancer although there is variability in the quality of the exam performed by different physicians,” Dr. Wallace says. “In previous studies done at Mayo Clinic Florida, we have demonstrated that a quality monitoring and improvement program substantially increases the quality of colonoscopy, as measured by the ability to detect precancerous polyps. This study provides further proof that quality improvement programs are necessary.”
Dr. Wallace adds that patients should be vigilant about the colonoscopy they are scheduled to receive. “The best way to determine the quality of the exam is asking the doctor ‘what is your adenoma detection rate’ with acceptable rates by 25% or higher,” he says.
Author Contact Michael Wallace, MD, MPH, Mayo Clinic
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