Mobile health technology in quality assessment of pediatric ileocolonoscopy: Results of the SIGENP national program.

Abstract

Background and study aims: Currently, there is no formal quality assessment of pediatric gastrointestinal endoscopy. We innovatively used mobile health (mHealth) technology to determine the quality of pediatric ileocolonoscopy (IC) in Italy.

Methods: Between April 2019 and March 2021, we prospectively collected data (demographics, procedure information, pre/intra/post-procedure indicators, patient satisfaction questionnaires) from the Italian Society of Pediatric Gastroenterology, Hepatology, and Nutrition using the ENDO-PED mobile app.

Results: Of 3410 registered procedures, 827 ICs were analyzed. Mean patient age was 11.1 ± 4.7 years. The most frequent indication was IBD follow-up or diagnosis (57.9%). Therapeutic ICs accounted for 11%, with polypectomy being the most common procedure. Among pre-procedure indicators, waiting time < 30 days was reported in 70.7%, informed consent was signed in 99.8% of cases, and 90.8% of patients completed > 90% of bowel preparation. In terms of intra-procedure indicators, deep sedation was the most commonly used method (77.8%). A high level of bowel cleansing was achieved in 87.4% of patients, with a terminal ileal (TI) intubation rate of 91.6%. Mean IC time with and without TI intubation was 24.2 ± 15.5 and 22.6 ± 15.6 minutes, respectively ( P =0.2). Regarding post-procedure indicators, late complications occurred in three children (0.4%), and a final report was issued in 96% of cases, with 67.2% being completed after more than 15 days.

Conclusions: mHealth was effective in assessing the quality of pediatric endoscopy. Levels of bowel preparation, sedation, TI intubation rate, and safety were adequate in Italy, whereas waiting time and post-procedure communication seemed to be the most critical areas of concern.