Improving Guideline Adherence to Surveillance Recommendations After Polypectomy
Posted: Tuesday, January 29, 2019
According to a retrospective cohort study by Amit G. Singal, MD, MS, and Celette Sugg Skinner, PhD, of The University of Texas Southwestern Medical Center, and colleagues, implementation of a colonoscopy reporting system may regulate colonoscopy-based screening recommendations. Due to previous findings that many endoscopists often recommended surveillance intervals that were too short, too long, or nonexistent, the authors sought to determine whether a tool would help providers adhere to the U.S. Multi-Society Task Force on Colorectal Cancer screening guidelines. Their methodology and results were published in JNCCN–Journal of the National Comprehensive Cancer Network.
In this study, surveillance recommendations provided to patients after polypectomy at Parkland Health and Hospital System were assessed for guideline adherence prior to and after implementation of the electronic medical record–based Colonoscopy Pathology Reporting and Clinical Decision Support System (CoRS). In the pre-CoRS and post-CoRS cohorts, the recommendations for 1,822 and 1,320 patients were analyzed, respectively.
For the duration of the study, provider usage of CoRS was high (89.8%). After about 1 year of usage, guideline-adherent surveillance recommendations for the post-CoRS cohort were more common (84.6%) than for the pre-CoRS cohort (77.4%). In cases of nonadherence for both the pre-CoRS and post-CoRS cohorts, recommendation overuse was most common (14.4% vs. 10.8%), followed by recommendation underuse (4.7% vs. 3.1%) and no recommendation (3.5% vs. 1.4%). To obtain the maximum benefit from CoRS, the authors recommend continual education and training for new users.
“Although the efficacy of CoRS would be best evaluated using a randomized controlled trial or step-wedge design, our study has the benefit of characterizing its effectiveness at improving surveillance recommendations when implemented as part of routine clinical care,” the authors concluded.
Disclosure: The study authors’ disclosure information may be found at jnccn.org.