Defining and Measuring Endoscopic Complications: More Questions than Answers

Canadian Credentialing Guidelines for Esophagogastroduodenoscopy

“…Given the rapid advances that are occurring in endoscopy and the need to maintain endoscopic privileges, a formalized system of ongoing training and monitoring is warranted. Institutions that grant privileges for EGD should be encouraged to develop endoscopic reporting mechanisms and databases so that practitioners may monitor the quality of their practice and effect improvements if they identify deficiencies (60,61). ACKNOWLEDGEMENTS: This manuscript was produced with the invaluable assistance of Pauline Lavigne, and the members of the Endoscopy Committee and Clinical Affairs Committee of the Canadian Association of Gastroenterology.…”

“…Given the broadening indications and rapid advances that are occurring in endoscopy, a formalized system of ongoing training and monitoring is warranted. Institutions that grant privileges for EGD should be encouraged to develop endoscopic reporting mechanisms and databases so that practitioners may monitor the quality of their practice and effect improvements if they identify deficiencies (60,61). American Society for Gastrointestinal Endoscopy guidelines on quality and outcomes assessment for gastrointestinal endoscopy (62) recommend the use of endoscopic records, and a record of outcomes for all patients undergoing endoscopy; such data would allow benchmarks to be established for the evaluation of endoscopists' subsequent performance.…”

A lexicon for endoscopic adverse events: report of an ASGE workshop

“…11,12 Studies have shown that many more AEs are found when patients are contacted at 30 days. 9,[27][28][29] However, the longer the delay is, the greater the chance that the event is not causally connected.…”

“…12 It hampers the comparison of data from different research and quality improvement studies. It makes individual studies suspect because practitioners may not be consistent in their own perceptions and definitions.…”

Splenic Perforation following Colonoscopy

“…Moreover, providers who are now being told that their outcomes data will be made publicly available and will serve as basis for changes in their payments and referral patterns have an incentive to under report the complications. This especially happens when the interpretation of what constitutes a complication is left to the discretion of the individual provider [19]. With introduction of large multicenter databases such as the CORI (Clinical Outcomes Research Initiative) project better estimates of complications should be available in future.…”