according to 116 respondents (24%, GE: 35%, nurses: 17%, p<0.01). 325 respondents(66%, GE: 55%, nurses: 74%, p<0.01) responded positively towards the disclosure of theresults of a QA program to the health authorities. Respondents were less positive to shareresults with insurers (57%; GE: 44%, nurses: 66%, p<0.01) and media (35%; GE: 22%,nurses: 44%, p<0.01). Most important quality indicators were proper patient information(97%), good aftercare (95%), and complete reporting (94%). Nurses rated patient-relatedparameters more important than GE, i.e. waiting lists (85 vs. 66%, p<0.01) and patientexperiences (96 vs. 86%, p<0.01). Clinical outcomes like complications (97 vs. 88%, p<0.01)and completeness of procedure (92 vs. 80%, p<0.05) were more important to GE. Genderand age were not significantly associated with the overall attitude towards QA. ConclusionEndoscopy personnel have a generally positive attitude towards QA. The results show thatGE and nurses prioritize different elements of a QA program. Additionally, GE have moreconcerns about the disclosure of QA results. Therefore, the implementation of a QA programshould be performed in close collaboration between all stakeholders of endoscopy.

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Results of Routine Endoscopy Performed in Patients With Morbid ObesityBefore Bariatric Surgery and Prevalence of Helicobacter pylori: A Single CenterStudy in 288 PatientsPauline Jouet, Julie Barbieri, Benoit Coffin, Simon Msika, Henri Duboc, Maggy Grossin,Mohamed Merrouche, Severine Ledoux, Muriel Coupaye, Benjamin Castel, NaimaSghiouar, Jean-Marc Sabate

Introduction The place of upper endoscopy in patients before bariatric surgery has evolved.It is currently recommended in most patients: in case of digestive symptoms before gastricbypass or sleeve gastrectomy, and for the presence of Helicobacter pylori. The aim of thisstudy was to describe 1) endoscopic findings before bariatric surgery, 2) histological dataand the prevalence of HP determined on antral biopsies. Patients and Methods An upperendoscopy was offered to all patients with morbid obesity (BMI> 40 kg/m2 and / or> 35kg/m2 with associated comorbidity) awaiting for bariatric surgery. The prevalence of Helicob-acter pylori found in antral biopsies in patients with morbid obesity was compared to thatfound in biopsies performed during the same period in the same center in nonobese patients.Results 288 patients, including 257 women (89.2%) had a gastric endoscopy before bariatricsurgery between June 2001 and June 2009. The mean age of patients was 39.58 ± 10.7years and mean BMI 46.0 ± 6.5 kg / m2. One or more lesions were identified in 192patients (66.7%). The esophagus was abnormal in 150 patients (52.1%) with the presenceof esophagitis in 33 patients (11.4%), grade I in 25, grade II in 7 and grade III in 1 patient.An aspect suggestive of Barrett esophagus was noted in 5 cases (1.7%) No patient hadesophageal varices. The cardia was abnormal in 138 cases (48%), with incompetent cardiain 44 cases (15,3%). Endoscopic gastritis was present in 45 cases (15.6%), duodenitis in13 cases (4.5%), gastric ulcer in 9 (3.1%) and duodenal ulcer in 2 patients (0.7% ). Gastricpolyps were present in 10 patients (3.5%) with glandulokystic histology in 7. Antral biopsieswere performed in 120 patients (41.7% of patients in the series). Helicobacter pylori waspresent in 60 cases (50%), a gastritis in 69 cases (57.5%), antral atrophy in 14 cases (11.7%)and no metaplasia was found. The prevalence of Helicobacter in patients with morbid obesitywas not different from that found in biopsies of non-obese patients (50% vs 42.5%, p = 0,11). Conclusion Upper gastrointestinal endoscopy performed systematically before bariatricsurgery was abnormal in two thirds of cases, showing most frequently abnormalities relatedto gastroesophageal reflux disease. Helicobacter pylori was found in half of patients withmorbid obesity, a prevalence not different from that found in non-obese patients.

Mo1124

Ironing out the Differences: Do We Adhere to British Society ofGastroenterology (BSG) Guidelines on Iron Deficiency Anemia (IDA)?Arun Rajendran, Pandurangan Basumani, Pierre J. Willemse, Karna D. Bardhan

Introduction: Despite BSG guidelines1 on IDA management, practice can be variable. There-fore we retrospectively audited our practice set in a district general hospital and analysedthe adherence, deviation and patient outcomes. Methods: 118 consecutive patients (Sept2009-Aug 2010) referred as “IDA” with no alarm symptoms and seen in a single GI clinicwere identified from database. 4 patients excluded-not iron deficient. Data on demography,clinical and laboratory assessments, endoscopy findings and follow up were extracted on aproforma and analysed. Results: 1.114 patients (M=49, F=65). As per BSG standards A.Allpatients had reasonable evidence of iron deficiency b.Celiac serology done-98% c.GI investi-gations in clinically unexplained IDA-93% 2.Completion rate of colonoscopy in patients 75yrs or older was comparable to younger patients (94% vs. 92%) 3.Colon cancer-5%, Celiacdisease-7% 4.93/100 had GI investigations as per BSG recommendations, conversely 8/14were over-investigated. Conclusions: 1.Demand for investigation of otherwise asymptomaticIDA is high. 2.Even in the absence of alarm symptoms, disease is common (46/114)-ofwhich 22/46 was significant. 3.Our pilot shows that assessment by single clinician led pathwayallows for BSG guidelines adherence and irons out variability. Reference: 1. Guidelines forthe management of iron deficiency anaemia, (BSG guidelines in Gastroenterology, May 2005).Diagnoses

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Mo1125

An Evaluation of the Quality of Colonoscopy (CS) Reporting in OntarioShane Hadlock, Linda Rabeneck, Michael Bernstein, Michael Gould, Ning Liu, Jill M.Tinmouth

BACKGROUND: The endoscopic report is often the only documentation of an endoscopicprocedure; as such, high quality reporting is essential to ensure good communication, toassess the quality of the procedure and for medico legal reasons. The few existing studieson colonoscopy (CS) reporting lack generalizability, as they have been single centre studiesor have been restricted to computer generated reports. OBJECTIVES: (1) To determine thequality of CS reporting in “usual practice” using established CS reporting standards and (2)to identify which factors are associated with poor CS reporting across multiple institutionswithin the province of Ontario. METHODS: The study cohort consisted of reports from 495randomly selected CS performed by 97 physicians across 10 Ontario hospitals in 2008-9which were linked to Ontario health administrative databases. We collected data on 34elements of the CS report, selected based on the 1999 ASGE CS reporting recommendationsand our expert panel consensus. A scoring system was developed a priori to designate reportsas “good” or “poor” quality. The administrative data were analyzed to determine procedure(open/non-open access) and physician characteristics (specialty, years in practice, annualCS volume, institution, polypectomy rates, CS completion rates). For the analysis, theproportion of reports documenting each CS report element was calculated. Univariate andmultivariate analyses were performed to compare “good” and “poor” quality CS reports.RESULTS: Procedure indication was documented in 91% of reports however sedation wasreported in only 68%.Documentation of cecal landmarks and quality of the bowel preparationwas present in 70% and 35% respectively. When polyps were found, less than half of reportsdocumented polyp size. A summary statement and follow up plan was present in 77% and76% of reports respectively. Of the 495 reports, 382 (77%) were considered “good” quality.Univariate analysis revealed that the quality of reporting varied by institution and at thephysician level for speciality, number of years in practice, CS completion and polypectomyrates. In the multivariate analysis, gastrointestinal specialty was associated with good qualityreports (OR 12.82, 4.15-40) compared to surgical specialty. CONCLUSIONS: Our study ofCS reporting in “usual practice” in Ontario reveals that an important proportion of reportsfail to document key quality indicators. The quality of CS reporting was associated withphysician specialty and annual CS volume. Standardized synoptic reporting using an elec-tronic medical record should be considered to address the quality issues identified in thecurrent practice of CS reporting in Ontario.

Mo1126

The Factors Affecting Polyp Detection Rate on the Timing of ColonoscopyJae Hak Kim, Min Keun Song, Chang Wook Park, Yung Suk Yoo, Jun Kyu Lee, MoonSoo Koh, Jin Ho Lee

Background & Aims: It has been demonstrated that colorectal adenoma detection rate issignificantly higher in morning colonoscopies than in afternoon colonoscopies. However,the affecting factors of this finding have not been determined. The aim of this study wasto investigate the influence of timing on colonoscopy on the polyp detection rate (PDR)and the physician's fatigue. Patients & Methods : The patients who underwent screeningcolonoscopy for the first time in their life in academic hospital were prospectively enrolledfrom July 2010 to August 2010. Data including age, gender, body mass index (BMI), historyof previous abdominal surgery, indication for colonoscopy, procedure starting time, andadequacy of bowel prepration were collected. If polyps were detected, the location, size,shape, and pathology were recorded. Also, data related with physician including the typeof previous procedure, the number of previous performed colonoscopy on duty, and thenumber of expected procedures on duty. Results: A total of 403 patients were enrolled. 209colonoscopies were performed in the morning and 194 were done in the afternoon. OverallPDR was 29.5% (119/403). According to starting time of colonoscopies, PDR was notstatistically different between morning group and afternoon group (27.8 % vs. 31.5%, p=.21). The factors associated with PDR were old age (p<.01), male gender (75.6% vs. 57.0%,p<.01), higher BMI (24.8 kg/m2 vs. 23.7kg/m2, p<.01), previous therapeutic procedure(1.7% vs. 8.1%, p=.02), and withdrawal time (8.5 min vs. 5.9 min, p=<.01). On a multivariateanalysis, old age (relative risk (RR), 5.0; 95% Confidence Interval (CI), 2.4 to 10.4; p=<.01)male gender (RR, 2.9; 95% CI, 1.6 to 5.3; p=<.01), previous therapeutic procedure (RR,0.2; 95% CI, 0.04 to 0.95; p=.043), and withdrawal time(≥ 6 min) (RR, 3.5; 95% CI, 2.0

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