Dutch Gastrointestinal Endoscopy Audit: Automated extraction of colonoscopy data for quality assessment and improvement

Abstract Background and Aims The importance of having quality assessment, assurance, and improvement tools in healthcare is increasingly recognized. However, the additional administration burden, which is still often associated therewith, progressively interferes with the structural implementation and adoption of such tools, especially when it concerns high-volume procedures such as colonoscopies. The development of the Dutch Gastrointestinal Endoscopy Audit (DGEA), a registry with automated extraction of colonoscopy quality data, and its first results, are described. Methods In close cooperation with commercial endoscopy reporting systems and a national histopathology database, healthcare professionals performing colonoscopies initiated a quality registry that extracts data from its core hospital resource or histology database without manual interference of the healthcare providers. Data extracted consisted of patients' age, gender, indication of the colonoscopy, ASA-score, Boston Bowel Preparation Score, Cecal intubation, and for the colonoscopy after a positive FIT in the colorectal cancer screening program also the polyp detection rate, which was available for all 48 hospitals or endoscopy centers, and adenoma detection rate, which was available for 26 hospitals or endoscopy centers. Results Between 1 January 2016 and 31 March 2019, 48 hospitals or endoscopy centers voluntarily participated in the DGEA and 275,017 unique patients with 313,511 colonoscopies were registered. Overall missing values were limited to Conclusions The results of this study demonstrate that it is feasible to deploy a quality registry collecting uniform data without additional administration burden for the healthcare professionals.