The effect of train-the-colonoscopy-trainer course on colonoscopy quality indicators

Geir Hoff; Edoardo Botteri; Gert Huppertz-Hauss; Jan Magnus Kvamme; Øyvind Holme; Lars Aabakken; Stein Dahler; Asle W. Medhus; Ingrid Blomgren; Per Sandvei; Ole Darre-Næss; Øystein Kjellevold; Birgitte Seip

doi:10.1055/a-1352-4583

Endoscopy, Inhaltsverzeichnis

Endoscopy 2021; 53(12): 1229-1234
DOI: 10.1055/a-1352-4583

Original article

The effect of train-the-colonoscopy-trainer course on colonoscopy quality indicators

Geir Hoff

¹Department of Research, Telemark Hospital Skien, Skien, Norway

³University of Oslo, Oslo, Norway

,

Edoardo Botteri

²Cancer Registry of Norway, Oslo, Norway

,

Gert Huppertz-Hauss

⁴Department of Medicine, Telemark Hospital Skien, Skien, Norway

,

Jan Magnus Kvamme

⁵Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway

⁶Department of Medicine, University Hospital, North Norway, Tromsø, Norway

,

Øyvind Holme

²Cancer Registry of Norway, Oslo, Norway

⁷Institute of Health and Society, University of Oslo, Oslo, Norway

⁸Department of Medicine, Sørlandet Hospital Kristiansand, Kristiansand, Norway

,

Lars Aabakken

⁹Department of Transplantation Medicine, Oslo University Hospital Rikshospitalet and Faculty of Medicine, University of Oslo, Oslo, Norway

,

Stein Dahler

¹⁰Department of Medicine, Telemark Hospital Notodden, Notodden, Norway

,

Asle W. Medhus

¹¹Department of Gastroenterology, Oslo University Hospital, Oslo, Norway

,

Ingrid Blomgren

¹²Department of Medicine, Helse Fonna Hospital Trust, Haugesund, Norway

,

Per Sandvei

¹³Department of Gastroenterology, Østfold Hospital Trust, Kalnes, Norway

,

Ole Darre-Næss

¹⁴Department of Medicine, Vestre Viken Hospital Trust, Bærum, Norway

,

Øystein Kjellevold

¹⁵Department of Medicine, Telemark Hospital Kragerø, Kragerø, Norway

,

Birgitte Seip

²Cancer Registry of Norway, Oslo, Norway

¹⁶Department of Medicine, Vestfold Hospital, Tønsberg, Norway

› Institutsangaben

Abstract

Background Systematic training in colonoscopy is highly recommended; however, we have limited knowledge of the effects of “training-the-colonoscopy-trainer” (TCT) courses. Using a national quality register on colonoscopy performance, we aimed to evaluate the effects of TCT participation on defined quality indicators.

Methods This observational study compared quality indicators (pain, cecal intubation, and polyp detection) between centers participating versus not participating in a TCT course. Nonparticipating centers were assigned a pseudoparticipating year to match their participating counterparts. Results were compared between first year after and the year before TCT (pseudo)participation. Time trends up to 5 years after TCT (pseudo)participation were also compared. Generalized estimating equation models, adjusted for age, sex, and bowel cleansing, were used.

Results 11 participating and 11 nonparticipating centers contributed 18 555 and 10 730 colonoscopies, respectively. In participating centers, there was a significant increase in detection of polyps ≥ 5 mm, from 26.4 % to 29.2 % (P = 0.035), and reduction in moderate/severe pain experienced by women, from 38.2 % to 33.6 % (P = 0.043); no significant changes were found in nonparticipating centers. Over 5 years, 20 participating and 18 nonparticipating centers contributed 85 691 and 41 569 colonoscopies, respectively. In participating centers, polyp detection rate increased linearly (P = 0.003), and pain decreased linearly in women (P = 0.004). Nonparticipating centers did not show any significant time trend during the study period.

Conclusions Participation in a TCT course improved polyp detection rates and reduced pain experienced by women. These effects were maintained during a 5-year follow-up.

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