Quality Indicators for Colonoscopy Procedures

Colonoscopy remains the gold standard for morphologic colon. Despite the development of new methods of morphologic bowel, colonoscopy is still considered the « gold standard » because of its ability at detecting small neoplasic lesions as well as adenomas. Unlike other methods, colonoscopy has the great advantage of carrying out the same time the removal of polyps. Colonoscopy also has a number of limitations. Studies have confirmed that the colonoscopy examination was an improvement over the performance review that fluctuates depending on the quality of it. Thus Pickardt et al showed that colonoscopy could miss up to 10% of polyps greater than 10mm (1). Also, it should be noted that interval cancers after colonoscopy is not uncommon (2). These results underpin the idea that colonoscopy is an examination of improvement and it is necessary to define quality criteria. The most famous of all is the detection rate of adenoma. This simple criterion was used to compare the performance of endoscopists (3). To reduce variation between endoscopists and to generalize the practice of colonoscopy quality, we must have reliable and easily measurable criteria for assessing the quality of examinations. These criteria should ensure that consideration is medically justified. It is carried out by using standard validated, that lesions are diagnosed correctly and appropriate treatments are made. All of it should be done with minimal risk to patients. Moreover, these criteria must evaluate the entire examination and not just the technical act. Those criteria must also take into account: the information provided to the patient, risk assessment, and conditions of the act. Indications for colonoscopy and appropriate intervals have been established by the taskforce in 2006 between the American College of Gastroenterology and the American Society of Digestive Endoscopy (4).