Endoscopy plays an important role in the diagnosis and management of digestive diseases. It is estimated that more than 20 million endoscopic procedures are performed annually in the United States. The Clinical Outcomes Research Initiative (CORI) was developed in the 1990's to collect endoscopy data from diverse practice settings with goal of measuring utilization and outcomes to improve the practice of endoscopy. The consortium includes endoscopists in 70 practices, who use a computer to generate endoscopy reports which are sent electronically to a central data repository. The repository receives more than 260,000 reports annually. The consortium has completed both descriptive analyses of endoscopy practice and prospective studies. CORI has been funded by NIDDK since 1999, and produced 47 manuscripts in peer-reviewed journals covering a broad range of topics in endoscopy, and received other federal and foundation grants to support specific research projects.
The specific aim of the current proposal is to use the existing endoscopic data repository and consortium to perform research which will improve the quality of endoscopic practice. There are three primary themes. Theme 1: analysis of practice. These studies will identify opportunities for improving practice by first identifying current practice patterns, and measuring key endoscopic outcomes. We will determine "best practices" and changes in practice over time. Theme 2: improving quality of endoscopic practice. We will measure endoscopic quality indicators and study the impact of interventions designed to achieve best practices. These interventions will include embedding educational guidelines into computer software and providing personal quality assurance reports to individual providers. Theme 3: This unique data repository will be a resource to the research and public health community in the United States and abroad.

Public Health Relevance

Endoscopy represents one of the most commonly performed invasive procedures in the United States. CORI has performed the first studies to measure the quality of endoscopic practice in diverse practice settings. The primary goals of the current proposal are to use the endoscopic database to monitor practice over time to identify areas for quality improvement, and to develop interventions to improve quality.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Research Project--Cooperative Agreements (U01)
Project #
5U01DK057132-15
Application #
8530222
Study Section
Special Emphasis Panel (ZDK1-GRB-C (M1))
Program Officer
Serrano, Jose
Project Start
1999-09-30
Project End
2014-08-31
Budget Start
2013-09-01
Budget End
2014-08-31
Support Year
15
Fiscal Year
2013
Total Cost
$1,025,413
Indirect Cost
$344,384
Name
Oregon Health and Science University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
096997515
City
Portland
State
OR
Country
United States
Zip Code
97239
Lieberman, David A; Williams, J Lucas; Holub, Jennifer L et al. (2014) Race, ethnicity, and sex affect risk for polyps >9 mm in average-risk individuals. Gastroenterology 147:351-8; quiz e14–5
Lieberman, David A; Holub, Jennifer L; Morris, Cynthia D et al. (2014) Low rate of large polyps (>9 mm) within 10 years after an adequate baseline colonoscopy with no polyps. Gastroenterology 147:343-50
Ron-Tal Fisher, Osnat; Gralnek, Ian M; Eisen, Glenn M et al. (2014) Endoscopic hemostasis is rarely used for hematochezia: a population-based study from the Clinical Outcomes Research Initiative National Endoscopic Database. Gastrointest Endosc 79:317-25
Lieberman, David A; Williams, J Lucas; Holub, Jennifer L et al. (2014) Colonoscopy utilization and outcomes 2000 to 2011. Gastrointest Endosc 80:133-43
Bielawska, Barbara; Day, Andrew G; Lieberman, David A et al. (2014) Risk factors for early colonoscopic perforation include non-gastroenterologist endoscopists: a multivariable analysis. Clin Gastroenterol Hepatol 12:85-92
Calderwood, Audrey H; Schroy 3rd, Paul C; Lieberman, David A et al. (2014) Boston Bowel Preparation Scale scores provide a standardized definition of adequate for describing bowel cleanliness. Gastrointest Endosc 80:269-76
Nason, Katie S; Murphy, Thomas; Schindler, Joshua et al. (2013) A cross-sectional analysis of the prevalence of Barrett esophagus in otolaryngology patients with laryngeal symptoms. J Clin Gastroenterol 47:762-8
Gralnek, Ian M; Ron-Tal Fisher, Osnat; Holub, Jennifer L et al. (2013) The role of colonoscopy in evaluating hematochezia: a population-based study in a large consortium of endoscopy practices. Gastrointest Endosc 77:410-8
Enestvedt, Brintha K; Eisen, Glenn M; Holub, Jennifer et al. (2013) Is the American Society of Anesthesiologists classification useful in risk stratification for endoscopic procedures? Gastrointest Endosc 77:464-71
Williams, Jason E; Holub, Jennifer L; Faigel, Douglas O (2012) Polypectomy rate is a valid quality measure for colonoscopy: results from a national endoscopy database. Gastrointest Endosc 75:576-82

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