Polypectomy rate as a quality measure for colonoscopy

Background The adenoma detection rate (ADR) has been proposed as a robust quality indicator for colonoscopy, but it is cumbersome to calculate and not available at the time of colonoscopy. Objective To determine whether endoscopists' polypectomy rates (PRs) correlate with their ADRs and to calculate benchmark PRs that correlate with benchmark ADRs. Design Retrospective study. Setting University and Veterans Affairs endoscopy units in Portland, Oregon. Subjects Fifteen endoscopists and their patients. Main Outcome Measurements Proportion of patients with any adenoma and any polyp removed; correlation between ADRs and PRs. Results Fifteen endoscopists performed 2706 average-risk screening colonoscopies during the study. There was variation in the ADR for men (15.4%-44.7%) and women (6.1%-25.8%) and in the PRs for men (17.9%-66.0%) and women (11.3%-43.1%). Endoscopists' PRs correlated well with their ADRs ( r s = 0.86, P P P = .01) than those who did not. Limitations Study endoscopists' approach to polypectomy may differ from that of endoscopists in other settings. Conclusions The PR is a useful quality measure with a high degree of correlation with the ADR.