title: Variation of quality of colonoscopy in Italy over five years: a nation-wide observational study.
abstract: OBJECTIVE
  A nation-wide survey of colonoscopy practice carried out in 2004 showed disappointing data on colonoscopy quality in Italy. Present study was aimed prospectively at re-evaluating quality indicators of colonoscopy and their changes over a five-year-period.
  
  
  METHODS
  The main features of each Endoscopy Unit and performance indicators on consecutive colonoscopies performed in a 2-week period were recorded. Variation of colonoscopy quality was assessed by comparing caecal-intubation and polyp-detection rates in present survey with those collected five-years before; statistical analysis was restricted to centres participating in both data collections.
  
  
  RESULTS
  6158 colonoscopies from 116 centres were evaluated; unadjusted caecal-intubation rate was 83.0%, with 21.6% centres reporting a value >90%; mean polyp-detection rate was 32.0% (range 9.6-71.2% across centres). To assess variation of performance indicators, 4452 procedures from 77 centres were compared to 3589 procedures performed five-years before, in the same centres. A significant difference between the two rounds of data collections was observed for both caecal-intubation (82.6% versus 80.9%, p=0.043) and polyp-detection (31.3% versus 28.1%, p=0.002). However, 52 centres maintained a caecal-intubation rate constantly <90%.
  
  
  CONCLUSIONS
  Present data show that colonoscopy in Italy is still far below quality standards and that a significant improvement of practice did not occur over the last five years. Strategies to enhance colonoscopy quality should be pursued by professional societies.
authors.affiliation: Gastroenterology Unit, Valduce Hospital, Como, Italy. francoradaelli@virgilio.it
authors.forename: Franco
authors.initials: F
authors.lastname: Radaelli
authors.forename: Silvia
authors.initials: S
authors.lastname: Paggi
authors.forename: Giorgio
authors.initials: G
authors.lastname: Minoli
mesh_terms: D000368:Aged; D002432:Cecum; D015331:Cohort Studies; D003111:Colonic Polyps / Q000175:diagnosis; D003113:Colonoscopy / Q000592:standards*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000592:standards / Q000706:statistics & numerical data; D007558:Italy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019984:Quality Indicators, Health Care / Q000592:standards*; D011795:Surveys and Questionnaires