Background Colorectal Cancer (CRC) is the third most diagnosed cancer and the second leading cause of cancer death in the United States. Colonoscopy is an essential tool for screening, used both as a primary approach and follow-up to an abnormal stool-based CRC screening result. Colonoscopy quality is often measured with four key indicators: bowel preparation, cecal intubation, mean withdrawal time, and adenoma detection. Colonoscopies are most often performed by gastroenterologists (GI), however, in rural and medically underserved areas non-GI providers often perform colonoscopies. This study aims to evaluate the quality and safety of screening colonoscopies performed by non-GI providers, comparing their outcomes to those of GI providers. Methods Descriptive statistics were used to characterize the study population. Results for quality indicators were stratified by provider type and compared. Statistical significance was determined using p < 0.05 as the threshold for all comparisons; all p-values were two-sided. Results No statistical difference was found when comparing performance by provider type. Median performance for gastroenterologists, general surgeons, and family medicine providers ranged form 98—100% for cecal intubation; 97.4—100% for bowel preparation; 57.4—88.9% for male adenoma detection rate; 47.7—62.13% for female adenoma detection rate; and 0:12:10—0:20:16 for mean withdrawal time. All provider types met and exceeded the goal metric for each of the quality indicators (p < 0.001). In this analysis, non-GI providers can be expected to perform colonoscopies with similar quality to GI providers based on performance outcomes for the key quality metrics.

中文翻译：

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通过执行提供者类型评估结肠镜检查质量

背景结直肠癌 (CRC) 是美国第三大诊断癌症，也是癌症死亡的第二大原因。结肠镜检查是筛查的重要工具，既可以作为主要方法，也可以作为粪便性结直肠癌筛查结果异常的后续检查。结肠镜检查质量通常通过四个关键指标来衡量：肠道准备、盲肠插管、平均撤药时间和腺瘤检出。结肠镜检查通常由胃肠病学家 (GI) 进行，然而，在农村和医疗服务不足的地区，非胃肠病学家经常进行结肠镜检查。本研究旨在评估非胃肠道提供者进行的结肠镜检查筛查的质量和安全性，并将其结果与胃肠道提供者的结果进行比较。方法 使用描述性统计来描述研究人群的特征。质量指标的结果按提供者类型进行分层并进行比较。使用p＜1确定统计显着性。 0.05作为所有比较的阈值；所有 p 值都是双向的。结果 按提供商类型比较绩效时未发现统计差异。胃肠病学家、普通外科医生和家庭医学提供者在盲肠插管方面的中位表现范围为 98-100%；肠道准备97.4—100%；男性腺瘤检出率57.4—88.9%；女性腺瘤检出率47.7—62.13%；平均提款时间为 0:12:10—0:20:16。所有提供商类型均达到并超过了每个质量指标的目标指标 (p < 0.001)。在此分析中，根据关键质量指标的绩效结果，非 GI 提供者预计将执行与 GI 提供者类似质量的结肠镜检查。