Quality metrics reflecting patient experience of gastrointestinal endoscopy in inflammatory bowel disease: results of national endoscopy dataset analysis
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Date
2026-01-09
Authors
Jones, Fiona
Lavelle, Aonghus
MacCarthy, Finbar
Patchett, Stephen
Morcos, Ashraf
Moloney, Manus
Cullen, Garret
Slattery, Eoin
Leyden, Jan
O’Morain, Colm
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Abstract
Introduction: The European Society of Gastrointestinal Endoscopy has recently defined important performance measures for endoscopy in inflammatory bowel disease (IBD). The role of patient experience in quality assessment of endoscopy in IBD has yet to be defined. We undertook an observational study based on analysis of a large multi-center dataset with national coverage in Ireland. The aim was to analyze individual and composite metrics that reflect patients’ experience with endoscopic procedures for IBD. Methods: Anonymized data were extracted from electronic procedure records of patients who underwent colonoscopy in 24 Irish hospitals. The performance indicator of colonic intubation (PICI), a novel composite score reflecting sedation rates and patient comfort, and IBD-specific endoscopic domains were evaluated. Results: Data from 261 524 colonoscopies were analysed from 2014 to 2020. Crohn’s disease (CD) patients had a significantly lower odds ratio (OR) of achieving PICI compared to non-IBD patients (0.69, 0.65-0.74, P < .001). Severe colitis was also associated with a significantly lower OR of achieving PICI (OR 0.53, 0.38-0.74, P < .001). In total, 80.2% of CD patients had a comfort score ≤2 compared to 87.8% of those with ulcerative colitis (UC) and 84.2% without IBD. Additionally, 60.7% of patients with CD required a midazolam dose of 3 mg or more compared to 50.4% of those with UC and 76.7% of those without IBD. In total, 50% of CD patients required fentanyl doses >50 µg compared to 34% of UC patients and 30.3% of patients without IBD. Conclusion: This analysis of a large national endoscopy dataset highlights variability in quality metrics for IBD endoscopy and underscores the need for a metric such as PICI to more accurately capture and reflect patient endoscopic experience with IBD.
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© 2026, the Author(s) . Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.
Keywords
Colonoscopy , Inflammatory bowel disease , Key performance indicators , Quality metrics , [APCMicrobiome] , [Medicine] , Gastroenterology
Citation
Jones, F, Lavelle, A, MacCarthy, F, Patchett, S, Morcos, A, Moloney, M, Cullen, G, Slattery, E, Leyden, J, O’Morain, C, Egan, L, Zammarchi, I, Iacucci, M & Doherty, G A 2026, 'Quality metrics reflecting patient experience of gastrointestinal endoscopy in inflammatory bowel disease: results of national endoscopy dataset analysis', Journal of Crohn's and Colitis, vol. 20, no. 6, jjaf211, pp. 1-10. https://doi.org/10.1093/ecco-jcc/jjaf211
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