TABLE 2.

Colonoscopy procedure data (entered in real time during each procedure)

1. When was this patient FIRST referred to you (when was your office FIRST contacted by any means such as phone, fax, etc)? 2. When did you have the consultation with the patient related to this colonoscopy? 3. Patient’s age □ 18–40 years □ 41–50 years □ 51–60 years □ 61–70 years □ >70 years 4. What is the reason for this colonoscopy? □ Investigation of symptoms or abnormal findings □ Screening □ Surveillance 5. What were the specific indications for this colonoscopy? (Check all that apply) □ Evidence of GI tract blood loss (including anemia) □ Positive FOBT □ Family history of colon cancer (first-degree relative) □ Diarrhoea □ Constipation □ Abdominal pain □ Unexplained weight loss □ Exacerbation of inflammatory bowel disease □ Stable inflammatory bowel disease >10 years □ Previous colon cancer □ Previous colon polyps □ Abnormality on other investigation (DCBE, CT) □ Other 6. When was this patient’s last colonoscopy? □ Never □ <1 year ago □ 1–2 years ago □ 2–5 years ago □ 5–10 years ago □ >10 years ago Procedural times 7. To time stamp START of colonoscopy, tap advance arrow 8. To time stamp reaching cecum or furthest extent of examination, tap advance arrow 9. To time stamp start of scope withdrawal, tap advance arrow 10. To time stamp completion of colonoscopy, tap advance arrow 11. What was the furthest extent that you reached? (Check only one) □ No further than splenic flexure <program skips to Q#15> □ No further than hepatic flexure <program skips to Q#14> □ Past hepatic flexure; cecum not seen □ Appendiceal orifice & ileocecal valve seen □ Terminal ileum inspected Ottawa Bowel Preparation Scale 12. Fluid in whole colon: □ Small □ Moderate □ Large □ Not applicable 13. Cleanliness of the RIGHT colon □ Excellent: Mucosal detail visible, no/clear fluid, almost no stool. □ Good: Turbid fluid/stool but mucosa visible, wash/suction not needed. □ Fair: Fluid/stool obscuring mucosa, seen with suction, wash not needed. □ Poor: Stool obscures, OK view with suction/wash □ Inadequate: Stool obscures despite major wash/suction 14. Cleanliness of the MID colon □ Excellent: mucosal detail visible, no/clear fluid, almost no stool □ Good: Turbid fluid/stool but mucosa visible, wash/suction not needed □ Fair: Fluid/stool obscuring mucosa, seen with suction, wash not needed □ Poor: Stool obscures, OK view with suction/wash □ Inadequate: Stool obscures despite major wash/suction 15. Cleanliness of the RECTO-SIGMOID colon □ Excellent: Mucosal detail visible, no/clear fluid, almost no stool □ Good: Turbid fluid/stool but mucosa visible, wash/suction not needed □ Fair: Fluid/stool obscuring mucosa, seen w suction, wash not needed □ Poor: Stool obscures, OK view with suction/wash □ Inadequate: Stool obscures despite major wash/suction Procedural details 16. Did you take mucosal biopsies? □ No □ Yes 17. How many polyps did you remove? □ None □ 1 □ 2 □ 3 □ 4 □ 5 □ 6 or more 18. Did any complications occur during the colonoscopy? (Check all that apply) □ No complications □ Yes – bleeding □ Yes – perforation □ Yes – respiratory problems □ Yes – cardiac problems 19. What medications were administered? (Check all that apply) □ None □ Benzodiazepine (eg, diazepam, midazolam) □ Opiate (eg, meperidine, fentanyl) □ Antispasmodic (eg, hyoscine butylbromide) □ Propofol □ Other

CT Computed tomography; DCBE Double-contrast barium enema; FOBT Fecal occult blood test; GI Gastrointestinal