ArticleJournal of general internal medicine2016
Developing and Testing an Electronic Measure of Screening Colonoscopy Overuse in a Large Integrated Healthcare System.
Article in Journal of general internal medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 3 syntheses or guidelines pooled it, 34 citations in OpenAlex.
- An Estimate of the US Rate of Overuse of Screening Colonoscopy: a Systematic Review.Journal of general internal medicine · 2022Pooled it
- Pay-for-Performance and Veteran Care in the VHA and the Community: a Systematic Review.Journal of general internal medicine · 2018Pooled it
- Overuse of Health Care Services in the Management of Cancer: A Systematic Review.Medical care · 2017Pooled it
- Evaluating potential overuse of surveillance care in cancer survivors.Cancer medicine · 2023Trial
- An Estimate of Preventable Harms Associated With Screening Colonoscopy Overuse in the U.S.AJPM focus · 2025Article
- Adherence to Follow-Up Colonoscopy After a Positive Stool-Based Test in Patients Aged 45-49 Years: Real-World Differences Between Multitarget Stool DNA Testing and Fecal Immunochemical or Fecal Occult Blood Testing.Gastro hep advances · 2025Article
- Article
- Developing an electronic health record measure of low-value esophagogastroduodenoscopy for GERD at a large academic health system.BMJ open quality · 2023Article
- Variation in Low-Value Service Use Across Veterans Affairs Facilities.Journal of general internal medicine · 2023Article
- Development and validation of a new ICD-10-based screening colonoscopy overuse measure in a large integrated healthcare system: a retrospective observational study.BMJ quality & safety · 2023Observational
- Prevalence and Cost of Care Cascades Following Low-Value Preoperative Electrocardiogram and Chest Radiograph Within the Veterans Health Administration.Journal of general internal medicine · 2023Article
- An Analysis of 5 Years of Randomized Trials in Gastroenterology and Hepatology Reveals 52 Medical Reversals.Digestive diseases and sciences · 2022Review
- Leveraging Electronic Health Records to Measure Low-Value Screening Colonoscopy.The American journal of medicine · 2022Article
- Measuring and Improving Quality of Colonoscopy for Colorectal Cancer Screening.Techniques and innovations in gastrointestinal endoscopy · 2022Article
- Factors Associated With Low-Value Cancer Screenings in the Veterans Health Administration.JAMA network open · 2021Article
- Evaluation of Low-Value Diagnostic Testing for 4 Common Conditions in the Veterans Health Administration.JAMA network open · 2020Article
- Measuring 21 low-value hospital procedures: claims analysis of Australian private health insurance data (2010-2014).BMJ open · 2019Article
- Patient Attitudes Toward Individualized Recommendations to Stop Low-Value Colorectal Cancer Screening.JAMA network open · 2018Article
- Low-value care: an intractable global problem with no quick fix.BMJ quality & safety · 2018Article
- Developing indicators for measuring low-value care: mapping Choosing Wisely recommendations to hospital data.BMC research notes · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMost existing performance measures focus on underuse of care, but there is growing interest in identifying and reducing overuse.
objectiveWe aimed to develop a valid and reliable electronic performance measure of overuse of screening colonoscopy in the Veterans Affairs Health Care System (VA), and to quantify overuse in VA.
designThis was a cross-sectional study with multiple cross-sections. SUBJECTS: U.S. Veterans who underwent screening colonoscopy between 2011 and 2013. MAIN MEASURES: Overuse of screening colonoscopy, using a validated electronic measure developed by an expert workgroup. KEY
resultsCompared to results obtained from manual record review, the electronic measure was highly specific (97 %) for overuse, but not sensitive (20 %). After exclusion of diagnostic and high-risk screening or surveillance procedures, the validated electronic measure identified 88,754 average-risk screening colonoscopies performed in VA during 2013. Of these, 20,530 (23 %) met the definition for probable (17 %) or possible (6 %) overuse. Substantial variation in colonoscopy overuse was noted between Veterans Integrated Care Networks (VISNs) and between facilities, with a nearly twofold difference between the maximum and minimum rates of overuse at the VISN level and a nearly eightfold difference at the facility level. Overuse at the VISN and facility level was relatively stable over time.
conclusionsOveruse of screening colonoscopy can be measured reliably and with high specificity using electronic data, and is common in a large integrated healthcare system. Overuse measures, such as those we have specified through a consensus workgroup process, could be combined with underuse measures to improve the appropriateness of colorectal cancer screening.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.