Armstrong David, Hollingworth Roger, Gardiner Tara, Klassen Michael, Smith Wendy, Hunt Richard H, Barkun Alan, Gould Michael, Leddin Desmond
Division of Gastroenterology, McMaster University, Hamilton, Ontario.
Can J Gastroenterol. 2006 Jun;20(6):405-10. doi: 10.1155/2006/685960.
Practice audit is an important component of continuing professional development that may more readily be undertaken if it were less complex. This qualitative study assessed the use of personal digital assistants to facilitate data collection and review.
Personal digital assistants programmed with standard questionnaires related to upper gastrointestinal endoscopies (Practice Audit in Gastroenterology-Endoscopy ['PAGE-Endo']) and colonoscopies (PAGE-Colonoscopy ['PAGE-Colo']) were provided to Canadian gastroenterologists, surgeons and internists. Over a three-week audit period, participants recorded indications, and the expected (E) and reported (R) findings for each procedure. Thereafter, participants recorded compliance with reporting, the ease of use and value of the PAGE program, and their willingness to perform another audit.
Over 15 to 18 months, 173 participants completed PAGE-Endo (6168 procedures) and 111 completed PAGE-Colo (4776 procedures). Most respondents noted that PAGE was easy to use (99%), beneficial (88% to 95%), and that they were willing undertake another audit (92% to 95%). In PAGE-Endo, alarm features were prevalent (55%), but major reported findings were less common than expected: esophagitis (E 29.9%, R 14.8%), esophageal stricture (E 8.3%, R 3.6%), gastric ulcer (E 17.0%, R 4.7%), gastric cancer (E 4.3%, R 1.0%) and duodenal ulcer (E 11.5%, R 5.7%). In PAGE-Colo, more colonoscopies were performed for symptom investigation (55%) than for screening (25%) or surveillance (20%). There were marked interprovincial variations with respect to sedation, biopsies and technical aspects of colonoscopy.
Secure, real-time data entry with review of aggregate and individual data in the PAGE program provided an acceptable, straightforward methodology for accredited practice audit activities. PAGE has considerable potential for continuing professional development in gastroenterology and other specialties.
实践审计是持续专业发展的重要组成部分，如果其复杂性降低，可能更容易开展。这项定性研究评估了使用个人数字助理来促进数据收集和审查的情况。
为加拿大的胃肠病学家、外科医生和内科医生提供了预编程有与上消化道内镜检查（胃肠病学 - 内镜检查实践审计['PAGE - Endo']）和结肠镜检查（PAGE - 结肠镜检查['PAGE - Colo']）相关的标准问卷的个人数字助理。在为期三周的审计期间，参与者记录每个程序的适应证以及预期（E）和报告（R）的发现。此后，参与者记录报告的合规性、PAGE程序的易用性和价值以及他们进行另一项审计的意愿。
在15至18个月的时间里，173名参与者完成了PAGE - Endo（6168例程序），111名参与者完成了PAGE - Colo（4776例程序）。大多数受访者指出，PAGE易于使用（99%）、有益（88%至95%），并且他们愿意进行另一项审计（92%至95%）。在PAGE - Endo中，警报特征很普遍（55%），但报告的主要发现比预期少见：食管炎（E 29.9%，R 14.8%）、食管狭窄（E 8.3%，R 3.6%）、胃溃疡（E 17.0%，R 4.7%）、胃癌（E 4.3%，R 1.0%）和十二指肠溃疡（E 11.5%，R 5.7%）。在PAGE - Colo中，因症状调查进行的结肠镜检查（55%）多于筛查（25%）或监测（20%）。在结肠镜检查的镇静、活检和技术方面存在明显的省际差异。
PAGE程序中安全的实时数据录入以及汇总数据和个体数据的审查为认可的实践审计活动提供了一种可接受的、直接的方法。PAGE在胃肠病学和其他专业的持续专业发展方面具有相当大的潜力。
