Alberta Family Physician Electronic Endoscopy study: Quality of 1769 colonoscopies performed by rural Canadian family physicians

摘要

Objective To determine whether rural FP colonoscopists in Alberta are achieving benchmarks in colonoscopy quality. Design Prospective, multicentre observational study. Setting Alberta. Participants Nine FP colonoscopists. Main outcome measures Proportion of successful cecal intubations; proportion of patients aged 50 and older with pathologically confirmed adenomas; mean number of adenomas per colonoscopy; and serious adverse events related to colonoscopy. Results In this 6-month study, 9 rural FPs in Alberta performed 1769 colonoscopies. Overall, all key colonoscopy quality benchmarks were met or exceeded. The proportion of successful cecal intubations was 97.9% (95% CI 97.2% to 98.6%). The proportion of male and female patients aged 50 and older whose first-time colonoscopy results revealed an adenoma was 67.4% (95% CI 62.4% to 72.7%) and 51.1% (95% CI 45.5% to 56.7%), respectively. There were 120 adenomas, 36 advanced adenomas, and 1 colon cancer case per 100 colonoscopies. There were 2 postpolypectomy bleeds and no other serious complications. Conclusion Alberta rural FP colonoscopists are meeting benchmarks in colonoscopy quality. Ongoing electronic collection of endoscopy quality markers should be encouraged. Supporting and training rural FPs who perform endoscopy might help alleviate current wait times and improve access for rural Canadian patients.