Portland, Ore.

The five-year grant aims to help improve endoscopy practices nationwide

The Clinical Outcomes Research Initiative (CORI) based at Oregon Health & Science University has received a $2.5 million grant from the National Institutes of Health's National Institute of Diabetes, and Digestive and Kidney Diseases. The five-year grant will fund research and technology that could boost the quality of endoscopy practices nationwide.

The goal of CORI is to study the utilization and effectiveness of endoscopic procedures in diverse clinical practice settings and to determine what really works in day-to-day clinical practice. CORI was founded in 1995 under the auspices of the ASGE (American Society for Gastrointestinal Endoscopy) and now comprises 115 participating universities and other medical sites across the country.

The OHSU CORI office maintains the National Endoscopic Database, which stores and tracks trends and patterns in the care of patients with digestive diseases. Participating CORI sites receive gastroenterology software that enables them to collect patient outcomes data, which is then compiled and stored in the national database at OHSU. Every month CORI receives more than 20,000 clinical procedure reports from more than 750 physicians nationwide.

"We have found that the information maintained in the database really helps with benchmarking so that CORI sites around the country can see how they're doing at providing patient care compared with the rest of the region," said David Lieberman, M.D., F.A.C.G., executive director of CORI and professor of medicine and head of the Division of Gastroenterology in the OHSU School of Medicine. Lieberman initiated the program with the ASGE 10 years ago. "With this new NIH funding, we hope to be able to analyze the variation in practices, changes in practice over time, and the effect of new information and research on endoscopy.

"We also hope to be able to find a way to measure our endoscopic findings based on procedure indication and patient characteristics to identify patients most likely to have surgical complications," added Lieberman.

Lieberman also expects that the new prospective studies will be able to provide information about the type of endoscopic procedure being performed, the quality and any complications of the procedure, and diagnostic and therapeutic interventions. The prospective studies will investigate the effect of innovations in practice, such as capsule endoscopy and treatments for reflux.

One example of how a prospective study could improve patient care is to track whether endoscopy patients were prescribed an anticoagulant prior to surgery and how they fared with or without the blood thinner. Such information, once compiled and analyzed for all sites, could be useful in influencing how endoscopy patients are treated nationwide.

“The NIH has been a continuing supporter of our program and our technology,” said Lieberman. “This grant makes it possible for us to advance our research and at the same time, develop our technology for further data collection and analysis. We are thankful to the NIH for their progressive approach to our research and technology.”

For more information about CORI, go to www.cori.org. For more information about ASGE, go to www.asge.org.

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