Córdova Henry, Sánchez-Montes Cristina, Delgado-Guillena Pedro G, Morales Victor J, Sendino Oriol, González-Suárez Begoña, Cárdenas Andrés, Pellisé Maria, Araujo Isis K, Ginés Àngels, Llach Josep, Fernández-Esparrach Gloria
Unidad de Endoscopia, Servicio de Gastroenterología, Institut Clínic de Malalties Digestives i Metabòliques (ICMDiM), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Hospital Clínic, Universitat de Barcelona, Barcelona, España.
Unidad de Endoscopia, Servicio de Gastroenterología, Institut Clínic de Malalties Digestives i Metabòliques (ICMDiM), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Hospital Clínic, Universitat de Barcelona, Barcelona, España; Servicio de Gastroenterología, Hospital General de Granollers, Granollers, Barcelona, España.
Gastroenterol Hepatol. 2017 Nov;40(9):587-594. doi: 10.1016/j.gastrohep.2017.05.007. Epub 2017 Jun 23.
There is an opportunity for improvement in the recording and measuring of quality indicators. However, no previous experiences exist in our field in terms of their compliance in esophagogastroduodenoscopy (EGD).
To analyse compliance with EGD quality criteria and evaluate improvement after conducting a training programme.
Comparative study of 2 cohorts: one retrospective (control group) and one prospective (intervention group), before and after a training programme consisting of an information session and the report writing improvement programme. The quality indicators proposed by the American Society for Gastrointestinal Endoscopy and the American College of Gastroenterology were used.
A total of 1,200 EGDs were included in a sequential manner (600 in each group). Following the training programme, a significant improvement was observed in the following indicators: documented indication (93 vs. 99.8%; P<0.01), documented full examinations (94.7 vs. 97.3%; P<0.01), correct performance (63.7 vs. 87.9%; P<0.01), appropriate biopsies according to protocols (57.9 vs. 83.8%; P<0.01), photo-documentation of described lesions (84.1 vs. 94.9%; P<0.01), photo-documentation per segment (52.9 vs. 70.5%; P<0.01) and correct overall assessment (56,9 vs. 90.5%; P<0.01). Biopsies for coeliac disease, documented indication, full examination and correct performance, if it went ahead, exceeded the recommended standard.
A very simple training programme improves EGD quality indicators, with the majority reaching the standards recommended by the American Society for Gastrointestinal Endoscopy and the American College of Gastroenterology.
在质量指标的记录和测量方面存在改进的空间。然而，在我们这个领域，食管胃十二指肠镜检查（EGD）的质量指标合规情况尚无先例。
分析EGD质量标准的合规情况，并在开展培训项目后评估改进情况。
对两个队列进行对比研究：一个回顾性队列（对照组）和一个前瞻性队列（干预组），在一个由信息讲解和报告撰写改进项目组成的培训项目前后进行对比。采用了美国胃肠内镜学会和美国胃肠病学会提出的质量指标。
共依次纳入1200例EGD检查（每组600例）。培训项目实施后，在以下指标上观察到显著改善：记录的适应证（93%对99.8%；P<0.01）、记录的完整检查（94.7%对97.3%；P<0.01）、正确操作（63.7%对87.9%；P<0.01）、根据方案进行的适当活检（57.9%对83.8%；P<0.01）、所描述病变的照片记录（84.1%对94.9%；P<0.01）、每段的照片记录（52.9%对70.5%；P<0.01）以及正确的总体评估（56.9%对90.5%；P<0.01）。乳糜泻活检、记录的适应证、完整检查和正确操作（如果进行）超过了推荐标准。
一个非常简单的培训项目可改善EGD质量指标，大多数指标达到了美国胃肠内镜学会和美国胃肠病学会推荐的标准。
