Actual Adherence to Quality Measures in GIQuIC

About a third of U.S. gastroenterologists utilize the GI Quality Improvement Consortium (GIQuIC) registry, operated by the American Society for Gastrointestinal Endoscopy and the American College of Gastroenterology. This study examined adherence to U.S. recommendations for quality assessment in screening colonoscopy.

According to GIQuIC registry data, there were nearly 2.6 million colonoscopies in persons aged 50 to 75 years between 2016 and 2019 (just pre-pandemic). At least 90% of endoscopists met targets for adequate bowel preparation, cecal intubation rate, and adenoma detection rate (ADR); however, there was still a lot of variation between endoscopists in how far above the minimum ADR threshold they achieved.

There were more deficiencies regarding screening and surveillance recommendations. The fraction of normal screenings with a follow-up interval recommendation of <10 years was 12%. For examinations with 1 or 2 small tubular adenomas, 13.5% of recommendations were for less than the 5- to 10-year interval as recommended in the guidelines at that time. For patients with only small sessile serrated lesions, 30.7% received a recommended interval of <5 years. Conversely, 18.2% of patients with advanced serrated lesions and 6.3% with advanced adenomas received surveillance recommendations of >3 years.

The fraction of endoscopists with ≥90% adherence to the 10-year guideline after normal colonoscopies was 64.7%, and the fraction with ≥90% adherence to the 5- to 10-year recommendation for 1 or 2 small adenomas was 59.1%.