Unidad de Endoscopia, Servicio de Gastroenterología, ICMDiM, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalunya, España.
Unidad de Endoscopia, Servicio de Gastroenterología, ICMDiM, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalunya, España; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalunya, España; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), España.
Gastroenterol Hepatol. 2020 Dec;43(10):589-597. doi: 10.1016/j.gastrohep.2020.01.017. Epub 2020 Jul 14.
In a previous study we demonstrated that a simple training programme improved quality indicators of Oesophagogastroduodenoscopy (OGD) achieving the recommended benchmarks. However, the long-term effect of this intervention is unknown. The aim of this study was to assess the quality of OGDs performed 3 years after of having completed a training programme.
A comparative study of 2 cohorts was designed as follows: Group A included OGDs performed in 2016 promptly after a training programme and Group B with OGDs performed from January to March 2019, this group was also divided into 2 subgroups: subgroup B1 of Endoscopists who had participated in the previous training programme and subgroup B2 of Endoscopists who had not. The intra-procedure quality indicators proposed by ASGE-ACG were used.
A total of 1236 OGDs were analysed, 600 from Group A and 636 from Group B (439 subgroup B1 and 197 subgroup B2). The number of complete examinations was lower in Group B (566 [94.3%] vs. 551 [86.6%]; p<0.001). A significant decrease was observed in nearly all quality indicators and they did not reach the recommended benchmarks: retroflexion in the stomach (96% vs. 81%; p<0.001); Seattle biopsy protocol (86% vs. 50%; p=0.03), description of the upper GI bleeding lesion (100% vs. 62%; p<0.01), sufficient intestinal biopsy specimens (at least 4) in suspected coeliac disease (92.5% vs. 18%; p<0.001), photo documentation of the lesion (94% vs. 90%; p<0.05). Regarding the overall assessment of the procedure (including correct performance and adequate photo documentation), a significant decrease was also observed (90.5% vs. 62%; p<0.001). There were no differences between subgroups B1 and B2.
The improvement observed in 2016 after a training programme did not prevail after 3 years. In order to keep the quality of OGDs above the recommended benchmarks, it is necessary to implement continuous training programmes.
在之前的一项研究中，我们证明了一个简单的培训计划可以提高食管胃十二指肠镜检查（OGD）的质量指标，达到推荐的基准。然而，这种干预的长期效果尚不清楚。本研究的目的是评估在完成培训计划 3 年后进行的 OGD 的质量。
设计了以下两个队列的比较研究：A 组包括 2016 年在培训计划后立即进行的 OGD，B 组包括 2019 年 1 月至 3 月进行的 OGD，该组还分为两个亚组：亚组 B1 为参加过之前培训计划的内镜医师，亚组 B2 为未参加过的内镜医师。使用 ASGE-ACG 提出的术中质量指标。
共分析了 1236 例 OGD，600 例来自 A 组，636 例来自 B 组（439 例亚组 B1，197 例亚组 B2）。B 组完整检查的数量较低（566[94.3%]vs.551[86.6%]；p<0.001）。几乎所有的质量指标都有显著下降，且未达到推荐的基准：胃内反转（96%vs.81%；p<0.001）；西雅图活检方案（86%vs.50%；p=0.03），上消化道出血病变的描述（100%vs.62%；p<0.01），疑似乳糜泻时足够的肠道活检标本（至少 4 个）（92.5%vs.18%；p<0.001），病变的照片记录（94%vs.90%；p<0.05）。对于手术的整体评估（包括正确的操作和适当的照片记录），也观察到显著下降（90.5%vs.62%；p<0.001）。亚组 B1 和 B2 之间无差异。
在培训计划后的 2016 年观察到的改善在 3 年后并未持续。为了保持 OGD 的质量高于推荐的基准，需要实施持续的培训计划。
