{
  "abstract": "Introduction High-quality lower gastrointestinal (GI) endoscopy is central to inflammatory bowel disease (IBD) care, supporting diagnosis, disease assessment, and colorectal cancer screening and surveillance. The National Endoscopy Database (NED) captures near real-time UK endoscopy activity, but its utility for evaluating IBD-specific key performance indicators (KPIs) has not been investigated. We aimed to assess whether NED can report IBD-specific KPIs, describe the quality of IBD surveillance colonoscopy in current UK practice, and explore variation in practice and outcomes.Methods All colonoscopies uploaded to NED from 1 January-31 December 2024 were analysed. IBD procedures were classified as assessment or surveillance. NED-KPI feasibility was evaluated by assessing data completeness and reporting variation across endoscopy reporting systems. Multivariable mixed-effects logistic regression (random intercept: endoscopist) was used to examine factors associated with polyp detection, moderate/severe discomfort, withdrawal time ≥10 minutes, and dye-based chromoendoscopy use.Results Of 588,841 colonoscopies, 5.1% (n=30,115) were IBD assessment and 2.7% (n=15,971) IBD surveillance. Among IBD-specific KPIs, only ileal intubation rate was immediately measurable, which was below target in both assessment (73.2%, 95% CI 72.7-73.7) and surveillance (65.9%, 95% CI 67.9-71.2) procedures.Performance in IBD surveillance was high, with caecal intubation rates (96.1%, 95% CI 95.7-96.4), withdrawal time (median 13 minutes, IQR 9-19) and moderate/severe discomfort rates (3.6%, 95% CI 3.3-3.9) comparable to BCS procedures. Bowel preparation was only recorded as sufficient in 80.2% of cases (95% CI 79.6-80.8) compared with bowel cancer screening procedures (87.9%, 87.6-88.2). IBD procedures had the highest use of sedation compared to symptomatic and BCS procedures (IBD assessment 70.0%, 95% CI 69.5-70.5; IBD surveillance 67.6%, 66.9-68.3). A small proportion of endoscopists (18.9%) performed ≥1 surveillance procedure/month and delivered 57.1% of all surveillance. Odds of polyp detection were significantly higher in bowel cancer screeners (OR 1.24, 95% CI 1.04-1.47, p=0.02), and in endoscopists performing ≥1 surveillance procedure per month (OR 1.26, 95% CI 1.12-1.41, p<0.001). Procedures allocated 2.5 points of time or more demonstrated significantly greater odds of polyp detection (OR 1.40, 1.27-1.54, p<0.001).Conclusions The quality of IBD colonoscopy is high, although bowel cancer preparation is suboptimal. At present, NED cannot support routine reporting of all IBD-specific KPIs.Concentrating surveillance lists among endoscopists who perform these procedures regularly, and allocating sufficient procedural time, were both associated with significantly higher polyp detection. Targeted workforce planning, list organisation, and protection of adequate examination time are therefore likely to yield the greatest improvements in IBD surveillance outcomes.",
  "authors": [
    {
      "affiliations": [
        "Joint Advisory Group On GI Endoscopy, Exeter, United Kingdom"
      ],
      "name": "Keith Pohl"
    },
    {
      "affiliations": [
        "Oxford University Hospitals NHS Foundation Trust"
      ],
      "name": "Gaurav Nigam"
    },
    {
      "affiliations": [
        "King’s College Hospital NHS Foundation Trust"
      ],
      "name": "Alexandra Kent"
    },
    {
      "affiliations": [
        "Oxford University Hospitals NHS Foundation Trust"
      ],
      "name": "James East"
    },
    {
      "affiliations": [
        "Joint Advisory Group On GI Endoscopy, Exeter, United Kingdom"
      ],
      "name": "Nicholas Burr"
    },
    {
      "affiliations": [
        "Western General Hospital"
      ],
      "name": "Shahida Din"
    }
  ],
  "title": "P187 Evaluating quality in inflammatory bowel disease (IBD) surveillance colonoscopy: findings from the national endoscopy database (NED)",
  "uid": "c8497e9d-4270-5b92-913b-3582b13322b8"
}