Polypectomy rate is a valid quality measure for colonoscopy: results from a national endoscopy database

Background The adenoma detection rate (ADR) is one of the main quality measures for colonoscopy, but it is burdensome to calculate and is not amenable to claims-based reporting. Objective To validate the correlation between polypectomy rates (PRs) and ADRs by using a large group of endoscopists. Design Retrospective study. Setting Community and academic endoscopy units in the United States. Subjects Sixty endoscopists and their patients. Main outcome measurements Proportion of patients with any adenoma and any polyp removed; correlation between ADRs and PRs. Results In total, 14,341 screening colonoscopies were included, and there was high correlation between endoscopists' PRs and ADRs in men ( r s = .91, P s = .91, P P P P = .0006; women: 6.3% vs 3.0%, P = .01). Benchmark PRs of 40% and 30% correlated with ADRs greater than 25% and 15% for men and women, respectively. Limitation Retrospective analysis of a subset of a national endoscopic database. Conclusions Endoscopists' PRs correlate well with their ADRs. Given its clinical relevance, its simplicity, and the ease with which it can be incorporated into claims-based reporting programs, the PR may become an important quality measure.