Performance measures for lower gastrointestinal endoscopy: a European Society of Gastrointestinal Endoscopy (ESGE) quality improvement initiative

Abstract

The European Society of Gastrointestinal Endoscopy and United European Gastroenterology present a short list of key performance measures for lower gastrointestinal endoscopy. We recommend that endoscopy services across Europe adopt the following seven key performance measures for lower gastrointestinal endoscopy for measurement and evaluation in daily practice at a center and endoscopist level: rate of adequate bowel preparation (minimum standard 90%); cecal intubation rate (minimum standard 90%); adenoma detection rate (minimum standard 25%); appropriate polypectomy technique (minimum standard 80%); complication rate (minimum standard not set); patient experience (minimum standard not set); appropriate post-polypectomy surveillance recommendations (minimum standard not set). Other identified performance measures have been listed as less relevant based on an assessment of their importance, scientific acceptability, feasibility, usability, and comparison to competing measures.

High Efficacy of Repeating Colonoscopy by an Advanced Endoscopist after an Incomplete Colonoscopy

“…Quality guidelines currently recommend a cecal intubation rate ≥90% in all colonoscopies in routine clinical practice and ≥95% in screening colonoscopies [2, 7, 9-14]. Nevertheless, reported rates of cecal intubation are suboptimal ranging from 76.9 to 89.1% in clinical practice and from 91 to 97.7% in screening colonoscopy [1, 7, 12].…”

The Boston Bowel Preparation Scale: Is It Already Being Used?

“…It is also easy to learn and simple to use in clinical routine practice. Therefore, the BBPS is the ESGE’s preferred bowel quality scale to use according to its recently published guideline “Performance Measures for Lower Gastrointestinal Endoscopy: A European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative” [10]. If you are not using it yet, you certainly should (learn how to use it here: http://www.cori.org/bbps/).…”

High Quality Preparation to Colonospcopy Is a Key to Exact Diagnostics

“…К ним относятся [11][12][13]: ■ показатели на доэндоскопическом этапе: наличие адекватных показаний, выбор времени для исследования, ■ показатель полноты выполнения: частота интубации слепой кишки ≥90%, ■ показатели выявления патологических изменений: ADR ≥25%, которое, в свою очередь, связано с адекватной продолжительностью извлечения эндоскопа, ■ показатели качества вмешательств: должное выполне-ние полипэктомии в ≥80% случаев, что определяется по частоте улавливания и извлечения резецированных по-липов, данным эндоскопического маркирования участ-ков полипэктомии, данным других методов визуализации, возможности адекватно описывать морфологию полипов; ■ также необходимо принимать во внимание частоту ос-ложнений, индивидуальный опыт специалиста и должную организацию последующего наблюдения -показатели, которые не всегда поддаются количественной оценке.…”