title: Polypectomy rate is a valid quality measure for colonoscopy: results from a national endoscopy database.
abstract: 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.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Community and academic endoscopy units in the United States.
  
  
  METHODS
  Sixty endoscopists and their patients.
  
  
  METHODS
  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 < .0001) and women (r(s) = .91, P < .0001). Endoscopists with PRs in the highest quartile had a significantly higher ADR than did those in the lowest quartile in men (44.6% vs 19.4%, P < .0001) and women (33.6% vs 11.6%, P < .0001). Endoscopists in the top polypectomy quartile also found more advanced adenomas than did endoscopists in the bottom quartile (men: 9.6% vs 4.6%, 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of Gastroenterology, Department of Medicine, Santa Clara Valley Medical Center, San Jose, California 95128, USA.
authors.forename: Jason E
authors.initials: JE
authors.lastname: Williams
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Holub
authors.forename: Douglas O
authors.initials: DO
authors.lastname: Faigel
mesh_terms: D000236:Adenoma / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D003111:Colonic Polyps / Q000601:surgery*; D003113:Colonoscopy / Q000592:standards* / Q000706:statistics & numerical data*; D015179:Colorectal Neoplasms / Q000601:surgery*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies