Jamie Catlow
Nationally Automated Colonoscopy Performance Feedback Increases Polyp Detection: the NED APRIQOT Randomised Controlled Trial.
Catlow, Jamie; Sharp, Linda; Wagnild, Janelle; Lu, Liya; Bhardwaj-Gosling, Rashmi; Ogundimu, Emmanuel; Kasim, Adetayo; Brookes, Matthew; Lee, Thomas; McCarthy, Stephen; Gray, Joanne; Sniehotta, Falko; Valori, Roland; Westwood, Claire; McNally, Richard; Ruwende, Josephine; Sinclair, Simon; Deane, Jill; Rutter, Matt
Authors
Linda Sharp
Janelle Wagnild j.m.wagnild@durham.ac.uk
Honorary Fellow
Liya Lu
Rashmi Bhardwaj-Gosling
Dr Emmanuel Ogundimu emmanuel.ogundimu@durham.ac.uk
Associate Professor
Adetayo Kasim
Matthew Brookes
Thomas Lee
Stephen McCarthy
Joanne Gray
Falko Sniehotta
Roland Valori
Claire Westwood
Richard McNally
Josephine Ruwende
Simon Sinclair
Jill Deane
Matt Rutter
Abstract
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. 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. 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). 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.
Citation
Catlow, J., Sharp, L., Wagnild, J., Lu, L., Bhardwaj-Gosling, R., Ogundimu, E., Kasim, A., Brookes, M., Lee, T., McCarthy, S., Gray, J., Sniehotta, F., Valori, R., Westwood, C., McNally, R., Ruwende, J., Sinclair, S., Deane, J., & Rutter, M. (2024). Nationally Automated Colonoscopy Performance Feedback Increases Polyp Detection: the NED APRIQOT Randomised Controlled Trial. Clinical Gastroenterology and Hepatology, 22(9), 1926-1936. https://doi.org/10.1016/j.cgh.2024.03.048
Journal Article Type | Article |
---|---|
Acceptance Date | Mar 29, 2024 |
Online Publication Date | May 15, 2024 |
Publication Date | May 15, 2024 |
Deposit Date | Jun 11, 2024 |
Publicly Available Date | Jun 11, 2024 |
Journal | Clinical Gastroenterology and Hepatology |
Print ISSN | 1542-3565 |
Electronic ISSN | 1542-3565 |
Publisher | Elsevier |
Peer Reviewed | Peer Reviewed |
Volume | 22 |
Issue | 9 |
Pages | 1926-1936 |
DOI | https://doi.org/10.1016/j.cgh.2024.03.048 |
Keywords | Detection, Quality improvement, Audit and feedback, Endoscopy |
Public URL | https://durham-repository.worktribe.com/output/2471616 |
Files
Published Journal Article (Advance Online Version)
(997 Kb)
PDF
Publisher Licence URL
http://creativecommons.org/licenses/by-nc-nd/4.0/
Published Journal Article
(862 Kb)
PDF
Publisher Licence URL
http://creativecommons.org/licenses/by-nc-nd/4.0/
You might also like
Minithoracotomy vs Conventional Sternotomy for Mitral Valve Repair
(2023)
Journal Article
Downloadable Citations
About Durham Research Online (DRO)
Administrator e-mail: dro.admin@durham.ac.uk
This application uses the following open-source libraries:
SheetJS Community Edition
Apache License Version 2.0 (http://www.apache.org/licenses/)
PDF.js
Apache License Version 2.0 (http://www.apache.org/licenses/)
Font Awesome
SIL OFL 1.1 (http://scripts.sil.org/OFL)
MIT License (http://opensource.org/licenses/mit-license.html)
CC BY 3.0 ( http://creativecommons.org/licenses/by/3.0/)
Powered by Worktribe © 2024
Advanced Search