Lisboa-Gonçalves Pedro, Libânio Diogo, Marques-Antunes Joana, Dinis-Ribeiro Mário, Pimentel-Nunes Pedro
Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal.
Gastroenterology Department, Portuguese Oncology Institute of Porto, Porto, Portugal.
GE Port J Gastroenterol. 2018 Dec;26(1):24-32. doi: 10.1159/000487145. Epub 2018 Apr 3.
In contrast to colonoscopy, there are few studies regarding upper gastrointestinal (UGI) endoscopy reporting its quality and ways of improving it. Quality audits are recommended, but their influence on the abovementioned quality is not well studied. Our aim was to evaluate the quality of UGI endoscopy reports and assess the effect of a simple audit intervention on UGI endoscopy reporting quality.
This was a prospective study in a tertiary referral center, including the evaluation of 1,000 consecutive reports of UGI endoscopies before an audit intervention and 250 after. The reports were analyzed according to performance measures defined by three experienced gastroenterologists.
Before the intervention, 51.8% of the incomplete endoscopies did not present any justification for its incompleteness and 88.1% of lesions were correctly described. Overall, 64.1% of the reports were considered as being of high quality. After the audit intervention, follow-up recommendation (53.4 vs. 80.8%, = 0.001), correct lesion description (88.1 vs. 95.8%, = 0.001), and correct segment description (92.2 vs. 96.4%, = 0.020) improved significantly. The rate of unjustified incomplete endoscopies decreased significantly (51.8 vs. 28.9%, = 0.010). The high-quality endoscopy rate improved 13.9% after the intervention ( < 0.001). Both specialists and residents improved with the audit intervention with a similar percentage of improvement in the high-quality endoscopy rate (13.9 vs. 13.4%).
A simple audit intervention is a good way to improve the quality of reporting of UGI endoscopy, independently of degree and experience. Some of the performance measure accomplishments may depend on the software used by the endoscopy centers and it should be a priority to optimize it.
与结肠镜检查不同，关于上消化道（UGI）内镜检查质量及其改进方法的研究较少。推荐进行质量审核，但对上述质量的影响尚未得到充分研究。我们的目的是评估UGI内镜检查报告的质量，并评估一项简单审核干预对UGI内镜检查报告质量的影响。
这是一项在三级转诊中心进行的前瞻性研究，包括在审核干预前评估1000份连续的UGI内镜检查报告，以及干预后评估250份报告。根据三位经验丰富的胃肠病学家定义的性能指标对报告进行分析。
干预前，51.8%的不完整内镜检查未对其不完整性给出任何理由，88.1%的病变得到正确描述。总体而言，64.1%的报告被认为质量较高。审核干预后，随访建议（53.4%对80.8%，P = 0.001）、病变正确描述（88.1%对95.8%，P = 0.001）和节段正确描述（92.2%对96.4%，P = 0.020）均有显著改善。无正当理由的不完整内镜检查率显著降低（51.8%对28.9%，P = 0.010）。干预后高质量内镜检查率提高了13.9%（P < 0.001）。专家和住院医师在审核干预后均有改善，高质量内镜检查率的改善百分比相似（13.9%对13.4%）。
一项简单的审核干预是提高UGI内镜检查报告质量的好方法，与学历和经验无关。一些性能指标的完成情况可能取决于内镜检查中心使用的软件，优化软件应成为优先事项。
