title: Public reporting of colonoscopy quality is associated with an increase in endoscopist adenoma detection rate.
abstract: BACKGROUND
  Colonoscopy is the predominant method for colorectal cancer screening in the United States. Previous studies have documented variation across physicians in colonoscopy quality as measured by the adenoma detection rate (ADR). ADR is the primary quality measure of colonoscopy examinations and an indicator of the likelihood of subsequent colorectal cancer. There is interest in mechanisms to improve the ADR. In Central Illinois, a local employer and a quality improvement organization partnered to publically report physician colonoscopy quality.
  
  
  OBJECTIVE
  We assessed whether this initiative was associated with an improvement in the ADR.
  
  
  METHODS
  We compared ADRs before and after public reporting at a private practice endoscopy center with 11 gastroenterologists in Peoria, Illinois, who participated in the initiative. To generate the ADR, colonoscopy and pathology reports from examinations performed over 4 years at the endoscopy center were analyzed by using previously validated natural language processing software.
  
  
  METHODS
  A central Illinois endoscopy center.
  
  
  RESULTS
  The ADR in the pre-public reporting period was 34.3% and 39.2% in the post-public reporting period (an increase of 4.9%, P < .001). The increase in the right-sided ADR was 5.1% (P < .01), whereas the increase in the left-sided ADR was 2.1% (P < .05). The increase in the ADR was 7.8% for screening colonoscopies (P < 0.05) and 3.5% for nonscreening colonoscopies (P < .05). All but 1 physician's ADR increased (range -2.7% to 10.5%). There was no statistically significant change in the advanced ADR (increase of 0.8%, P = .22).
  
  
  CONCLUSIONS
  There was no concurrent control group to assess whether the increased ADR was due to a secular trend.
  
  
  CONCLUSIONS
  A public reporting initiative on colonoscopy quality was associated with an increase in ADR.
authors.affiliation: University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
authors.forename: Heitham
authors.initials: H
authors.lastname: Abdul-Baki
authors.affiliation: University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
authors.forename: Robert E
authors.initials: RE
authors.lastname: Schoen
authors.affiliation: Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Katie
authors.initials: K
authors.lastname: Dean
authors.affiliation: Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Sherri
authors.initials: S
authors.lastname: Rose
authors.affiliation: Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Leffler
authors.affiliation: Central Illinois Endoscopy Center, Peoria, Illinois, USA.
authors.forename: Eliathamby
authors.initials: E
authors.lastname: Kuganeswaran
authors.affiliation: University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
authors.forename: Michele
authors.initials: M
authors.lastname: Morris
authors.affiliation: Group Health Cooperative Research Institute, Seattle, Washington, USA.
authors.forename: David
authors.initials: D
authors.lastname: Carrell
authors.affiliation: Harvard Medical School, Boston, Massachusetts, USA; Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
authors.forename: Ateev
authors.initials: A
authors.lastname: Mehrotra
mesh_terms: D022126:Access to Information; D000236:Adenoma / Q000175:diagnosis*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy / Q000592:standards* / Q000706:statistics & numerical data; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D055088:Early Detection of Cancer / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007087:Illinois; D033181:Information Dissemination; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation; D058996:Quality Improvement / Q000706:statistics & numerical data*; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies