title: Quality in the technical performance of screening flexible sigmoidoscopy: recommendations of an international multi-society task group.
abstract: BACKGROUND
  Flexible sigmoidoscopy (FS) is a complex technical procedure performed in a variety of settings, by examiners with diverse professional backgrounds, training, and experience. Potential variation in technical quality may have a profound impact on the effectiveness of FS on the early detection and prevention of colorectal cancer.
  
  
  OBJECTIVE
  We propose a set of consensus and evidence based recommendations to assist the development of continuous quality improvement programmes around the delivery of FS for colorectal cancer screening.
  
  
  CONCLUSIONS
  These recommendations address the intervals between FS examinations, documentation of results, training of endoscopists, decision making around referral for colonoscopy, policies for antibiotic prophylaxis and management of anticoagulation, insertion of the FS endoscope, bowel preparation, complications, the use of non-physicians as FS endoscopists, and FS endoscope reprocessing. For each of these areas, continuous quality improvement targets are recommended, and research questions are proposed.
authors.affiliation: Kaiser Permanente Division of Research, 2000 Broadway, 2nd Floor, Oakland, CA 94612, USA. Theodore.Levin@kp.org
authors.forename: T R
authors.initials: TR
authors.lastname: Levin
authors.forename: F A
authors.initials: FA
authors.lastname: Farraye
authors.forename: R E
authors.initials: RE
authors.lastname: Schoen
authors.forename: G
authors.initials: G
authors.lastname: Hoff
authors.forename: W
authors.initials: W
authors.lastname: Atkin
authors.forename: J H
authors.initials: JH
authors.lastname: Bond
authors.forename: S
authors.initials: S
authors.lastname: Winawer
authors.forename: R W
authors.initials: RW
authors.lastname: Burt
authors.forename: D A
authors.initials: DA
authors.lastname: Johnson
authors.forename: L M
authors.initials: LM
authors.lastname: Kirk
authors.forename: S C
authors.initials: SC
authors.lastname: Litin
authors.forename: D K
authors.initials: DK
authors.lastname: Rex
mesh_terms: D019072:Antibiotic Prophylaxis / Q000379:methods; D000925:Anticoagulants / Q000627:therapeutic use; D015179:Colorectal Neoplasms / Q000517:prevention & control*; D003107:Colorectal Surgery / Q000193:education; D042241:Early Diagnosis; D004502:Education, Medical, Continuing; D006801:Humans; D007258:Informed Consent; D008403:Mass Screening / Q000379:methods*; D008505:Medical Staff, Hospital / Q000193:education; D017060:Patient Satisfaction; D012017:Referral and Consultation; D012680:Sensitivity and Specificity; D012812:Sigmoidoscopy / Q000009:adverse effects / Q000379:methods / Q000592:standards*
chemical_list: D000925:Anticoagulants