{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T22:15:13Z","timestamp":1787004913693,"version":"build-2736575974"},"reference-count":0,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Background and study aim\u2002Cecal intubation rate (CIR) is an established performance indicator of colonoscopy. In some patients, cecal intubation with acceptable tolerance is only achieved with additional sedation. This study proposes a composite Performance Indicator of Colonic Intubation (PICI), which combines CIR, comfort, and sedation.<\/jats:p>\n                  <jats:p>Methods\u2002Data from 20\u2005085 colonoscopies reported in the 2011 UK national audit were analyzed. PICI was defined as the percentage of procedures achieving cecal intubation with median dose (2\u200amg) of midazolam or less, and nurse-assessed comfort score of 1\u200a\u2013\u200a3\/5.\u200aMultivariate logistic regression analysis evaluated possible associations between PICI and patient, unit, colonoscopist, and diagnostic factors.<\/jats:p>\n                  <jats:p>Results\u2002PICI was achieved in 54.1\u200a% of procedures. PICI identified factors affecting performance more frequently than single measures such as CIR and polyp detection, or CIR\u200a+\u200acomfort alone. Older age, male sex, adequate bowel preparation, and a positive fecal occult blood test as indication were associated with a higher PICI. Unit accreditation, the presence of magnetic imagers in the unit, greater annual volume, fewer years\u2019 experience, and higher training\/trainer status were associated with higher PICI rates. Procedures in which PICI was achieved were associated with significantly higher polyp detection rates than when PICI was not achieved.<\/jats:p>\n                  <jats:p>Conclusions\u2002PICI provides a simpler picture of performance of colonoscopic intubation than separate measures of CIR, comfort, and sedation. It is associated with more factors that are amenable to change that might improve performance and with higher likelihood of polyp detection. It is proposed that PICI becomes the key performance indicator for intubation of the colon in colonoscopy quality improvement initiatives.<\/jats:p>","DOI":"10.1055\/s-0043-115897","type":"journal-article","created":{"date-parts":[[2017,7,28]],"date-time":"2017-07-28T18:39:51Z","timestamp":1501267191000},"source":"Crossref","is-referenced-by-count":15,"title":["A new composite measure of colonoscopy: the Performance Indicator of Colonic Intubation (PICI)"],"prefix":"10.1055","author":[{"given":"Roland","family":"Valori","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Gloucestershire Hospitals NHS Foundation Trust, Gloucester, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Damery","sequence":"additional","affiliation":[{"name":"Department of Primary Care Clinical Sciences, School of Health and Population Sciences, University of Birmingham, Birmingham, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Gavin","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Ipswich Hospital NHS Trust, Ipswich, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Anderson","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Donnelly","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Surgery, The Royal Wolverhampton Hospitals NHS Foundation Trust, Wolverhampton, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edwin","family":"Swarbrick","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The Royal Wolverhampton Hospitals NHS Foundation Trust, Wolverhampton, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2017,7,28]]},"container-title":["Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0043-115897.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2017,12,19]],"date-time":"2017-12-19T03:56:57Z","timestamp":1513655817000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0043-115897"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,7,28]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1055\/s-0043-115897","relation":{},"ISSN":["0013-726X","1438-8812"],"issn-type":[{"value":"0013-726X","type":"print"},{"value":"1438-8812","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,7,28]]}}}