• Ateev Mehrotra, Evan S Dellon, Robert E Schoen, Melissa Saul, Faraz Bishehsari, Carrie Farmer, and Henk Harkema.
• Departments of Medicine and Biomedical Informatics, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA. mehrotra@rand.org
• Gastrointest. Endosc. 2012 Jun 1;75(6):1233-9.e14.

BackgroundGastroenterology specialty societies have advocated that providers routinely assess their performance on colonoscopy quality measures. Such routine measurement has been hampered by the costs and time required to manually review colonoscopy and pathology reports. Natural language processing (NLP) is a field of computer science in which programs are trained to extract relevant information from text reports in an automated fashion.ObjectiveTo demonstrate the efficiency and potential of NLP-based colonoscopy quality measurement.DesignIn a cross-sectional study design, we used a previously validated NLP program to analyze colonoscopy reports and associated pathology notes. The resulting data were used to generate provider performance on colonoscopy quality measures.SettingNine hospitals in the University of Pittsburgh Medical Center health care system.PatientsStudy sample consisted of the 24,157 colonoscopy reports and associated pathology reports from 2008 to 2009.Main Outcome MeasurementsProvider performance on 7 quality measures.ResultsPerformance on the colonoscopy quality measures was generally poor, and there was a wide range of performance. For example, across hospitals, the adequacy of preparation was noted overall in only 45.7% of procedures (range 14.6%-86.1% across 9 hospitals), cecal landmarks were documented in 62.7% of procedures (range 11.6%-90.0%), and the adenoma detection rate was 25.2% (range 14.9%-33.9%).LimitationsOur quality assessment was limited to a single health care system in western Pennsylvania.ConclusionsOur study illustrates how NLP can mine free-text data in electronic records to measure and report on the quality of care. Even within a single academic hospital system, there is considerable variation in the performance on colonoscopy quality measures, demonstrating the need for better methods to regularly and efficiently assess quality.Copyright © 2012 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

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