P0151 - Colonoscopy Quality Metrics: A Review of Clinical Practice in Abu Dhabi, United Arab Emirates

Emad Rahmani, MD, FACG¹, Mai Aljaber, MPH², Alaa Abuassi, RN³, Martine C. McManus, MD⁴, Jocelyn Daganio, RN^5
1Burjeel Hospital, Abu Dhabi, Abu Dhabi, United Arab Emirates; ²Healthpoint, Abu Dhabi, Abu Dhabi, United Arab Emirates; ³Burjeel Day Surgery Center, Abu Dhabi, Abu Dhabi, United Arab Emirates; ⁴SEHA, Abu Dhabi, Abu Dhabi, United Arab Emirates; ⁵Estia Health, Twin Waters, Queensland, Australia

Introduction: Adenoma detection rate (ADR) has been established as one of the most important parameters in colonoscopy quality indicators. There is a lack of data from evaluating application of this colonoscopy metrics in the Middle East. Furthermore; it is unknown if goals set in international guidelines are able to be achieved in a Middle East clinical practice.

Methods: In this study, we assessed colonoscopy quality measures including: preparation quality, cecal intubation rate, polyp detection rate, and complication rate in a consecutive cohort of patients undergoing colonoscopy in a large practice in a community hospital in Abu Dhabi (Healthpoint Hospital) from July 2015 to October 2017. The endpoints reviewed include procedure polyp detection rate, overall ADR, and sessile serrated polyp (SSP) detection rate. Quantitative metrics were collected to assess endpoints as compared to published Abu Dhabi Department of Health colonoscopy quality indicators.

Results: A total of 1727 patient underwent colonoscopic examination during this period ((M:808, F:919). ADR was 38% with 5% of sessile serrated polyp as reported by experienced gastrointestinal pathologists

Discussion: The Abu Dhabi standard of colonoscopy quality indicators is based on International guidelines published by the American College of Gastroenterology (ACG) and other gastroenterology societies reported adequate ADR to be of 25% adenoma detection rate in men and 15% adenoma detection rate in women. This is significantly lower than the percentages achieved by our group and consistent with recent published date from experienced endoscopists. Regarding colonoscopy quality metrics recommendations; we believe that local and international guidelines application in our population is achievable. Furthermore; it appears that the prevalence of colon adenomatous polyps and sessile serrated polyps are similar to reported prevalence in the western studies.

Indicator	Acceptable level	Desirable level	Current Data
Minimum number of screening colonoscopies undertaken annually by each screening colonoscopist		>150 per annum	1000
Bowel cleanliness at colonoscopy		≥ 90% bowel preparation described as excellent or adequate	98%
Cecal intubation rate (CIR). Follow-up and screening colonoscopies to be recorded separately (unadjusted CIR with photographic evidence)	>90%	>95%	99.8%
ADR	Auditable outcome	?	38%
Withdrawal time in negative colonoscopies (withdrawal from cecal pole to anus)		≥ 6 minutes	NA
Polyp retrieval rate (retrieval of polypectomy specimens for histological analysis per colonoscopist)		>90%	99.8%
Endoscopic complications of colonoscopy screening programs		Bleeding < 1:150 Perforation 1:1000	1:1000 0
Post polypectomy perforation rate		< 1:500	0

Table: National (Abu Dhabi Department of Health) Colonoscopy Quality Indicators Versus our Data


Disclosures:
Emad Rahmani indicated no relevant financial relationships.
Mai Aljaber indicated no relevant financial relationships.
Alaa Abuassi indicated no relevant financial relationships.
Martine McManus indicated no relevant financial relationships.
Jocelyn Daganio indicated no relevant financial relationships.


Emad Rahmani, MD, FACG¹, Mai Aljaber, MPH², Alaa Abuassi, RN³, Martine C. McManus, MD⁴, Jocelyn Daganio, RN⁵. P0151 - Colonoscopy Quality Metrics: A Review of Clinical Practice in Abu Dhabi, United Arab Emirates, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.