title: A novel quality scoring system for the evaluation of individual colonoscopy: A multicenter retrospective study.
abstract: OBJECTIVE
  It is essential to develop a novel evaluation system for the quality of individual colonoscopy and provide guidelines on whether and when to follow up the patient after the initial colonoscopy. This study aimed to establish and validate a scoring system for the quality of individual colonoscopy in terms of the adenoma miss rate (AMR).
  
  
  METHODS
  Patients undergoing two consecutive colonoscopies within 90 days between 2009 and 2011 from different levels of hospitals in China were enrolled into this study. Potential risk factors for adenoma miss at the individual colonoscopy in a cohort of patients were evaluated in univariate and multivariate analyses. Corresponding scores for the procedure-related factors were generated based on their weights, and a scoring system was established and then validated by correlating the system with AMR.
  
  
  RESULTS
  A total of 2093 patients were enrolled. Procedure-related factors at the individual colonoscopy (including bowel preparation and imaging methods), doctor experience, retroflexion, and withdrawal time were identified to be independent risk factors, and each of these factors was scored from 0 to 3. Then, a novel scoring system for the quality of individual colonoscopy (ranging from 0 to 9) was established, which was closely correlated with the AMRs in the establishment (adjusted R(2) = 0.845) and validation databases (adjusted R(2) = 0.733).
  
  
  CONCLUSIONS
  The developed and validated evaluation system, consisting of procedure-related independent factors, successfully assesses the quality of individual colonoscopy in terms of AMRs.
authors.affiliation: Guangdong Provincial Key Laboratory of Gastroenterology, Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province.|Department of Gastroenterology, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu Province.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Zhan
authors.affiliation: Department of Gastroenterology, Longgang Central Ho spital, Shenzhen, Guangdong Province.
authors.forename: Li
authors.initials: L
authors.lastname: Xiang
authors.affiliation: Department of Gastroenterology, Mianyang Central Hospital, Mianyang, Sichuan Province, China.
authors.forename: Xinhua
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Department of Biostatistics, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou.
authors.forename: Shengli
authors.initials: S
authors.lastname: An
authors.affiliation: Guangdong Provincial Key Laboratory of Gastroenterology, Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province.
authors.forename: Yadong
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Guangdong Provincial Key Laboratory of Gastroenterology, Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province.
authors.forename: Yangzhi
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Guangdong Provincial Key Laboratory of Gastroenterology, Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province.
authors.forename: Aimin
authors.initials: A
authors.lastname: Li
authors.affiliation: Guangdong Provincial Key Laboratory of Gastroenterology, Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province.
authors.forename: Wei
authors.initials: W
authors.lastname: Gong
authors.affiliation: Guangdong Provincial Key Laboratory of Gastroenterology, Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province.
authors.forename: Yang
authors.initials: Y
authors.lastname: Bai
authors.affiliation: Guangdong Provincial Key Laboratory of Gastroenterology, Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province.
authors.forename: Yali
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Guangdong Provincial Key Laboratory of Gastroenterology, Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province.
authors.forename: Side
authors.initials: S
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003113:Colonoscopy / Q000379:methods; D003951:Diagnostic Errors / Q000517:prevention & control / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D015999:Multivariate Analysis; D017410:Practice Guidelines as Topic; D011785:Quality Assurance, Health Care / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
keywords: adenoma miss; individual colonoscopy; quality evaluation; risk factors