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

## TL;DR

This study used mobile health technology to assess the quality of pediatric ileocolonoscopy procedures in Italy, finding that most aspects were adequate but waiting times and post-procedure communication need improvement.

## Contribution

The study introduces mHealth technology as a novel method for quality assessment in pediatric gastrointestinal endoscopy.

## Key findings

- Mobile health technology effectively assessed pediatric ileocolonoscopy quality in Italy.
- High rates of bowel cleansing and terminal ileal intubation were observed, but waiting times and post-procedure communication were critical areas.
- Late complications were rare, and most procedures had final reports issued.

## Abstract

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.

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.

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.

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.