Quality performance measures in upper gastrointestinal endoscopy for lesion detection: Italian AIGO-SIED-SIGE joint position statement

Francesco, Vincenzo De; Alicante, Saverio; Amato, Arnaldo; Frazzoni, Leonardo; Lombardi, G; Manfredi, Guido; Monica, Fabio; Sferrazza, Sandro; Vassallo, Roberto; Germanà, B.; Pasquale, Luigi; Annibale, Bruno; Cadoni, Sergio

doi:10.1016/j.dld.2022.06.028

Cited by 13 publications

(25 citation statements)

References 32 publications

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“…[28][29][30][31] Missed UGI cancer rates vary significantly among studies because of differences in EGD quality, status and strain of H. pylori infection, epidemiology, and pathologic diagnostic criteria. Although the Italian Association of Hospital Gastroenterologists and Digestive Endoscopists and BSG have recommended scheduled audits to ensure a missed UGI cancer rate below 10%, 32 it was essential to obtain evidence-based verification for universality of the standard.…”

Section: Current Statusmentioning

confidence: 99%

“…74 In light of this evidence, ESGE and Italian societies recommend a minimum inspection time (from intubation to extubation) of 7 min for the first EGD screening. 20,32 According to BSG guidelines, a standard diagnostic endoscopy requires at least a 20-min slot, which should be appropriately increased for surveillance or high-risk conditions. 21 A minimum 1-min inspection time per centimeter circumferential Barrett's epithelium and a minimum withdrawal time of 2 min for esophageal squamous cell carcinomas are recommended.…”

Section: Adequate Inspection Timementioning

confidence: 99%

“…In light of this evidence, ESGE and Italian societies recommend a minimum inspection time (from intubation to extubation) of 7 min for the first EGD screening 20,32 . According to BSG guidelines, a standard diagnostic endoscopy requires at least a 20‐min slot, which should be appropriately increased for surveillance or high‐risk conditions 21 .…”

Section: Adequate Inspection Timementioning

confidence: 99%

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Current status of quality control in screening esophagogastroduodenoscopy and the emerging role of artificial intelligence

Zhang

Yao

et al. 2023

Digestive Endoscopy

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Esophagogastroduodenoscopy (EGD) screening is being implemented in countries with high incidence of upper gastrointestinal cancer. High‐quality EGD screening ensured the yield of early diagnosis, prevention suffering from advanced upper gastrointestinal cancer, and minimal operational related discomfort. However, the performance varied dramatically among endoscopists, and the quality control for EGD screening remains sub‐optimal. Guidelines have recommended potential measures for endoscopy quality improvement and researches have been conducted for evidence. Moreover, artificial intelligence (AI) offers a promising solution for computer‐aided diagnosis and quality control during EGD examinations recently. In this review, we summarized the key points for quality assurance in EGD screening based on current guidelines and evidences. We also concluded the latest evidence, limitations, and future prospects of the emerging role of AI in EGD quality control, aiming to provide the foundation for improving the quality of EGD screening.

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Section: Current Statusmentioning

confidence: 99%

Section: Adequate Inspection Timementioning

confidence: 99%

Section: Adequate Inspection Timementioning

confidence: 99%

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Current status of quality control in screening esophagogastroduodenoscopy and the emerging role of artificial intelligence

Zhang

Yao

et al. 2023

Digestive Endoscopy

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“…To achieve this aim, searching for presence of atrophic gastritis and grading its extension in the stomach is advised by different guidelines [15][16][17]. In detail, taking at least 2 biopsies on antral and 2 on gastric body mucosa (an additional incisura angularis biopsy may be helpful) during upper endoscopy is strongly recommended as a prerequisite for upper endoscopy quality [15][16][17]. This gastric mucosa sampling also allows to correctly diagnose H. pylori infection, that is, the principal factor involved in the majority of gastroduodenal diseases, from dyspepsia to neoplastic lesions (cancer and MALT-lymphoma) [18].…”

Section: Why Testing Gastric Juice?mentioning

confidence: 99%

“…The quality of gastroscopy includes taking standard biopsy sampling of gastric mucosa in all appropriate examinations [15][16][17]. To avoid taking useless biopsies to test for both H. pylori infection and diffuse precancerous lesions on normal-appearing gastric mucosa, the realtime gastric juice examination may be highly useful.…”

Section: When Testing Gastric Juice Is Clinically Relevant?mentioning

confidence: 99%

Gastric juice analysis in clinical practice: why, how, and when. The experience with EndoFaster

Zullo,

Annibale,

Dinis-Ribeiro

et al. 2023

European Journal of Gastroenterology &Amp; Hepatology

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Gastric juice analysis may be useful for clinical purposes, including the detection of H. pylori infection and diffuse atrophic gastritis on gastric mucosa. EndoFaster is a novel device which performs real-time analysis of gastric juice revealing the infection and hypochlorhydria by measuring ammonium concentrations and pH levels. This review aimed to evaluate the clinical applications of such a tool. By considering data from overall 11 studies, the values of sensitivity, specificity, positive predictive value, negative predictive value, accuracy, positive likelihood ratio, and negative likelihood ratio were 90%, 86%, 67%, 96%, 87%, 8.5, and 0.13, respectively, for H. pylori diagnosis, and 83%, 92%, 58%, 97%, 91%, 9.9 and 0.2, respectively, for suspecting diffuse atrophic gastritis. The very high value of negative predictive values for both H. pylori and mucosal atrophy would allow avoiding to perform useless negative gastric biopsies when the results of the test are negative. Some promising data suggest that gastric juice analysis may be useful also to diagnose H. pylori infection in patients with chronic active gastritis without evidence of bacteria at histology, as well as in predicting persistent acid reflux in patients on proton pump inhibitor therapy for reflux disease.

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Ability of detection in different resolution endoscopy for upper gastrointestinal mucosal lesions

Jin,

Zhou,

Lyu

et al. 2024

Surg Endosc

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Background Most endoscopists believe that higher resolution improves lesion detection rates. However, existing studies primarily compared the detection rates of white light endoscopy (WLE) and other imaging modalities. Our previous study demonstrated the advantages of magnifying endoscopy from general endoscopy for lesion detection, prompting further investigation into the variations in lesion detection rates across endoscopes with different resolutions. Methods Endoscopic and corresponding pathological data from our medical unit over the past 5 years were analyzed. We excluded specific-purpose endoscopic procedures to ensure the natural randomization of the data. Baseline adjustment and risk factor analyses used multi-group propensity score matching and logistic regression. Results The overall lesion detection rate was significantly higher with high-quality endoscopy (Q-endoscopy) compared to high-definition endoscopy (H-endoscopy) and high definition and quality endoscopy (HQ-endoscopy) (34.4% vs. 30.2% vs. 29.6%, P = 0.001). Similar results were observed for elevated lesions (25.7% vs. 21.0% vs. 22.9%, P = 0.001) and depressed lesions (6.6% vs. 6.2% vs. 3.6%, P < 0.001). HQ-endoscopy had a superior detection rate for superficial lesions compared to both H- and Q-endoscopies (3.0% vs. 2.8% vs. 1.8%, P = 0.041). However, there were no significant differences in neoplastic detection rate or missed neoplastic lesion rate among the three groups. Conclusion Q-endoscopy is superior in detecting non-superficial lesions, while HQ-endoscopy is better at detecting superficial lesions. However, there were no statistically significant differences in detecting or omitting neoplastic lesions among the three endoscopic examinations.

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Quality performance measures in upper gastrointestinal endoscopy for lesion detection: Italian AIGO-SIED-SIGE joint position statement

Cited by 13 publications

References 32 publications

Current status of quality control in screening esophagogastroduodenoscopy and the emerging role of artificial intelligence

Current status of quality control in screening esophagogastroduodenoscopy and the emerging role of artificial intelligence

Gastric juice analysis in clinical practice: why, how, and when. The experience with EndoFaster

Ability of detection in different resolution endoscopy for upper gastrointestinal mucosal lesions

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