Clinical Endoscopy

Review

Quality indicators in endoscopic retrograde cholangiopancreatography: a brief review of established guidelines: Zubin Dev Sharma, Rajesh Puri; Clin Endosc 2023;56(3):290-297. Published online April 11, 2023; DOI: https://doi.org/10.5946/ce.2022.210

Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive endoscopic technique that has many diagnostic and therapeutic implications. It is a procedure with small but significant life-threatening complications. To ensure the best possible care, minimize complications, and improve the quality of health care, a constant review of the performance of the operator using ideal benchmark standards is needed. Hence, quality indicators are necessary. The American and European Societies of Gastrointestinal Endoscopy have provided guidelines on quality measures for ERCP, which describe the skills to be developed and training to be implemented in performing quality ERCP. These guidelines have divided the indicators into pre-procedure, intraprocedural, and post-procedure measures. The focus of this article was to review the quality indicators of ERCP.

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Original Article

Exploring quality indicators for the detection of Helicobacter pylori-naïve gastric cancer: a cross-sectional nationwide survey: Fumiaki Ishibashi, Toshiaki Hirasawa, Hiroya Ueyama, Yohei Minato, Sho Suzuki; Clin Endosc 2023;56(4):460-469. Published online April 4, 2023; DOI: https://doi.org/10.5946/ce.2022.167

Graphical Abstract Abstract PDF Supplementary Material PubReader ePub

Background
/Aims: Diagnosis of Helicobacter pylori-naïve gastric cancer (HPNGC) is becoming increasingly important. This study aimed to explore the quality indicators for HPNGC detection.
Methods
We conducted a cross-sectional, nationwide, web-based survey of gastrointestinal endoscopists in Japan. In addition to questions about the number of HPNGC cases detected in a year and basic information, the questionnaire also consisted of 28 questions: (1) 18 about HPNGC awareness, (2) six about diagnostic proactiveness, and (3) four about interest in HPNGC.
Results
Valid responses were obtained from 712 endoscopists. The Japan Gastroenterological Endoscopy Society-certified endoscopists had a significantly higher HPNGC detection rate than the nonspecialists (0.42% vs. 0.32%, respectively; p=0.008). The results of the multiple regression analysis showed that Japan Gastroenterological Endoscopy Society certification and high awareness and interest scores were independent predictors of the HPNGC detection rate (p=0.012, p<0.001, p=0.024, respectively). Principal component analysis showed that the endoscopists who attended conferences for collecting information on HPNGC had a higher level of awareness.
Conclusions
To improve the detection of HPNGC, it is necessary to increase the awareness of the disease. It is hoped that relevant societies will play an important role in endoscopists’ education.

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Review

Quality indicators in esophagogastroduodenoscopy: Sang Yoon Kim, Jae Myung Park; Clin Endosc 2022;55(3):319-331. Published online May 16, 2022; DOI: https://doi.org/10.5946/ce.2022.094

Abstract PDF PubReader ePub

Esophagogastroduodenoscopy (EGD) has been used to diagnose a wide variety of upper gastrointestinal diseases. In particular, EGD is used to screen high-risk subjects of gastric cancer. Quality control of EGD is important because the diagnostic rate is examiner-dependent. However, there is still no representative quality indicator that can be uniformly applied in EGD. There has been growing awareness of the importance of quality control in improving EGD performance. Therefore, we aimed to review the available and emerging quality indicators for diagnostic EGD.

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Original Article

Quality Indicators for the Detection of Helicobacter pylori-Negative Early Gastric Cancer: A Retrospective Observational Study: Fumiaki Ishibashi, Konomi Kobayashi, Keita Fukushima, Ryu Tanaka, Tomohiro Kawakami, Junko Kato, Kazuaki Sugihara; Clin Endosc 2020;53(6):698-704. Published online March 13, 2020; DOI: https://doi.org/10.5946/ce.2019.203

Abstract PDF PubReader ePub

Background
/Aims: While Helicobacter pylori (HP)-negative gastric cancer is frequently reported, little is known about the predictors for detecting HP-negative early gastric cancer (EGC). We aimed to evaluate the predictors for the detection of HP-negative EGC.
Methods
We retrospectively reviewed 13,477 consecutive asymptomatic cases where upper endoscopy was performed by nine physicians from April 2017 to March 2019 and analyzed the detection rate of high-risk lesions (HRLs), including EGC, tubular adenoma, and lymphoma, according to the status of HP infection. The observation time was corrected for multiple regression analyses.
Results
For all physicians, the average observation time for screening HP-eradicated and -naïve patients was shorter than that for screening HP-positive patients (p<0.05). Multiple regression analyses revealed that the observation time in the three groups was an independent predictor for detecting HRLs in HP-eradicated patients (p=0.03106, 0.01263, and 0.02485, respectively), while experience of endoscopy was an independent predictor for detecting HRLs in HP-naïve patients (p=0.02638).
Conclusions
While observation time during screening endoscopy was a quality indicator for detecting HRLs in HP-eradicated patients, experience of endoscopy was a quality indicator for detecting HRLs in HP-naïve patients.

Citations

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The Increasing Trend of the Generational Helicobacter pylori‐Naïve Prevalence Among Japanese Individuals Born Between 1925 and 2015: A Systematic Review and Meta‐Regression Analysis
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Helicobacter.2025;[Epub] CrossRef
A mathematical simulation model to determine the optimal endoscopic screening strategy for detection of H. pylori-naïve gastric neoplasms
Fumiaki Ishibashi, Kosuke Okusa, Yoshitaka Tokai, Toshiaki Hirasawa, Tomohiro Kawakami, Kentaro Mochida, Yuka Yanai, Chizu Yokoi, Yuko Hayashi, Shun-ichiro Ozawa, Koji Uraushihara, Yohei Minato, Hiroyuki Nakanishi, Hiroya Ueyama, Mikinori Kataoka, Yuzo To
Gastric Cancer.2024; 27(5): 1078. CrossRef
Exploring quality indicators for the detection of Helicobacter pylori-naïve gastric cancer: a cross-sectional nationwide survey
Fumiaki Ishibashi, Toshiaki Hirasawa, Hiroya Ueyama, Yohei Minato, Sho Suzuki
Clinical Endoscopy.2023; 56(4): 460. CrossRef
A Close Follow-Up Strategy in the Short Period of Time after Helicobacter pylori Eradication Contributes to Earlier Detection of Gastric Cancer
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Dong Chan Joo, Gwang Ha Kim
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Hee Seok Moon
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Youn I Choi, Jun-Won Chung, Kyoung Oh Kim, Kwang An Kwon, Yoon Jae Kim, Jung Ho Kim, Ja Young Seo, Dong Kyun Park
World Journal of Gastroenterology.2021; 27(31): 5247. CrossRef
Quality management system for screening esophagogastroduodenoscopy improves detection of Helicobacter pylori-negative interval gastric cancer
Fumiaki Ishibashi, Konomi Kobayashi, Tomohiro Kawakami, Ryu Tanaka, Kazuaki Sugihara, Satoshi Baba
Endoscopy International Open.2021; 09(12): E1900. CrossRef
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Review

Quality Indicators in Barrett’s Esophagus: Time to Change the Status Quo: Samuel Han, Sachin Wani; Clin Endosc 2018;51(4):344-351. Published online July 31, 2018; DOI: https://doi.org/10.5946/ce.2018.099

Abstract PDF PubReader ePub

The push for high quality care in all fields of medicine highlights the importance of establishing and adhering to quality indicators.In response, several gastrointestinal societies have established quality indicators specific to Barrett’s esophagus, which serve to createthresholds for performance while standardizing practice and guiding value-based care. Recent studies, however, have consistentlydemonstrated the lack of adherence to these quality indicators, particularly in surveillance (appropriate utilization of endoscopy andobtaining biopsies using the Seattle protocol) and endoscopic eradication therapy practices. These findings suggest that innovativeinterventions are needed to address these shortcomings in order to deliver high quality care to patients with Barrett’s esophagus.

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