Quality indicators for EGD

Park, Walter G.; Shaheen, Nicholas J.; Cohen, Jonathan; Pike, Irving M.; Adler, Douglas G.; Inadomi, John M.; Laine, Loren; Lieb, John G.; Rizk, Maged; Sawhney, Mandeep S.; Wani, Sachin

doi:10.1016/j.gie.2014.07.057

Cited by 123 publications

(122 citation statements)

References 78 publications

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“…Since the objective of the survey was to assess the endoscopic procedures performance in terms of quality, both ASGE and ESGE recommended quality indicators for GI endoscopic procedures were taken into account (8)(9)(10). These recommendations were adapted to the survey design and the endoscopic Spanish practice.…”

Section: Methodsmentioning

confidence: 99%

“…In order to identify these performance gaps and promote better practices to optimize endoscopic procedures among gastroenterologists, the main national and international scientific entities, such as the European and the American Societies of Gastrointestinal Endoscopy (ESGE and ASGE), have put forward a range of quality indicators for these tests (7)(8)(9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

“…Quality indicators for GI endoscopy are now well defined by scientific societies (7)(8)(9)(10)(11) and have been proven to deliver better health outcomes, better patient experience and fewer repeated procedures (11). However, the miss rates of pre-malignant and/or malignant lesions, which have been reported in several papers to interval and/or follow-up cancers (1-6), have not decreased over time (5,6).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A survey-based analysis on endoscopic quality indicators compliance among Spanish endoscopists

et al. 2016

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Introduction: Endoscopy plays a key role for the diagnosis and management of gastrointestinal disorders. Therefore, quality indicators have been widely proposed in order to optimize endoscopic practice. The aims of this study, promoted by the Spanish Society of Digestive Diseases (SEPD), were to assess the knowledge and compliance to endoscopy quality indicators among Spanish gastroenterologists.Methods: A 31-questionnaire survey was created based on the endoscopy quality indicators proposed by international guidelines. The survey was distributed among Spanish gastroenterologists who are members of the society. Using only fully completed surveys, a descriptive analysis was performed. Those factors related with a suboptimal quality performance were also investigated.Results: A total of 1,543 surveys were sent and 281 (18.2%) were received completed. Based on the answers obtained, the management of 14 (70%) out of 20 assessed quality indicators was poor: 5 (83.3%) out of 6 pre-procedure items, 7 (58.3%) out of 12 intra-procedure items and 2 (100%) out of 2 post-procedure items. Young age, public setting, no colorectal cancer (CRC) screening program at the institution and a low volume of procedures/week are factors related to poorer management of the assessed quality indicators.Conclusions: A significant proportion of Spanish endoscopists do not comply with main endoscopic quality indicators. Factors such as "young" age, public setting, no colorectal cancer screening program and low volume of procedures/week are related to a poorer management of the assessed quality indicators and should be the target for future formative activities.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A survey-based analysis on endoscopic quality indicators compliance among Spanish endoscopists

et al. 2016

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“…Although the JAG states that intubation success is an auditable outcome [1], no current key performance indicator exists. The Association for Gastrointestinal Endoscopy (ASGE) does not specifically mention IF [26], but states that complete examinations should be achieved in >98% of gastroscopies. Based on our data, and that from Reed et al [7], we propose that an IF rate of <1% is a realistic and auditable quality metric in gastroscopy.…”

Section: Predictors Of Abnormal Radiology In Patients With Ifmentioning

confidence: 99%

“…In clinical practice, patients are often deemed to not tolerate intubation due to factors such as anxiety, when these may be due to variations in oropharyngeal J Gastrointestin Liver Dis, December 2017 Vol. 26 No 4: 339-344 anatomy. So far, no published studies have explored whether patients fail intubation due to anxiety, or anatomical causes.…”

Section: Introductionmentioning

confidence: 99%

Intubation Failure During Gastroscopy: Incidence, Predictors and Follow-Up Findings

Siau

Fisher

et al. 2017

JGLD

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Background: Intubation failure (IF) occurs when an endoscopist is unable to progress via the oropharynx into the upper oesophagus. Aim: To assess incidence and aetiology of IF and predictors of structural pharyngeal abnormalities in patients with IF.Methods: All gastroscopies (n=26,130) performed in our centre, between August 2010 and August 2016 were retrospectively reviewed. Barium radiology and repeat gastroscopy findings were evaluated for structural causes of IF. Patients were categorised into ‘failure to tolerate’ and ‘failure to progress’ based on endoscopy reports.Results: The incidence of IF was 0.95%. Rates of IF varied with endoscopist specialty (p=0.021), but not with patient age, sex or sedation dose. Among cases of IF, structural pharyngeal abnormalities were detected on barium radiology in 28.9%, consisting of cricopharyngeal hypertrophy and/or Zenker’s diverticulum in 73.2%. ‘Failure to progress’ predicted pharyngeal pathology in 55.6%. Predictors of structural causes on barium radiology following IF included: age ≥65 (OR 4.0, 95% CI: 1.8-8.9, p<0.001); indication of dysphagia (OR 5.5, 95% CI: 2.5-11.8, p<0.001), and failure of endoscopic progression (OR 5.2, 95% CI: 2.3-12.0, p<0.001).Conclusion: Patients with IF should be investigated owing to the high risk of underlying pathology, particularly if associated with age ≥65, dysphagia, and failure of endoscopic progression. We propose that IF rates of <1% could be used as a quality indicator in gastroscopy. .Abbreviations: ASGE: Association for Gastrointestinal Endoscopy; CI: Confidence interval; CP: Cricopharyngeus; CPH: Cricopharyngeal hypertrophy; FESD: Flexible endoscopic septum division; GRS: Global rating scale; IF: Intubation failure; JAG: Joint Advisory Group for gastrointestinal endoscopy; NME: Non-medical endoscopist; OR: Odds ratio; SI: Successful intubation; ZD: Zenker’s diverticulum.

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Assessment of Cimetropium Bromide Use for the Detection of Gastric Neoplasms During Esophagogastroduodenoscopy

et al. 2022

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Key Points Question Is the use of cimetropium bromide, an antispasmodic agent, associated with higher rates of detection of gastric neoplasms during esophagogastroduodenoscopy (EGD) screening? Findings In this cohort study of 67 683 participants who received EGD screening, the use of cimetropium bromide as premedication was associated with higher gastric neoplasm detection rates during EGD than nonuse. Lesions in the gastric body were detected more frequently in those who received cimetropium bromide compared with those who did not. Meaning This study’s findings suggest that cimetropium bromide may be considered as premedication for the detection of gastric neoplasms during EGD examination among individuals with no contraindications.

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Quality indicators for EGD

Cited by 123 publications

References 78 publications

A survey-based analysis on endoscopic quality indicators compliance among Spanish endoscopists

A survey-based analysis on endoscopic quality indicators compliance among Spanish endoscopists

Intubation Failure During Gastroscopy: Incidence, Predictors and Follow-Up Findings

Assessment of Cimetropium Bromide Use for the Detection of Gastric Neoplasms During Esophagogastroduodenoscopy

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