Chair and department of Gastroenterology and Hepatology, School of Medicine in Katowice, Medical University of Silesia, Medyków 14 Street, 40-752, Katowice, Poland.
Endoterapia, H-T. Centrum Medyczne, Tychy, Poland.
J Gastroenterol. 2021 Jul;56(7):651-658. doi: 10.1007/s00535-021-01790-3. Epub 2021 May 2.
Esophagogastroduodenoscopy (EGD) is commonly used diagnostic method with no widely accepted quality measure. We assessed quality indicator-composite detection rate (CDR)-consisting of detection of at least one of the following: cervical inlet patch, gastric polyp and post-ulcer duodenal bulb deformation. The aim of the study was to validate CDR according to detection rate of upper gastrointestinal neoplasms (UGN).
It was a multicenter, prospective, observational study conducted from January 2019 to October 2019. The endoscopic reports from 2896 symptomatic patients who underwent diagnostic EGD were analyzed. The EGDs were performed in three endoscopy units located in tertiary university hospital, private outpatient clinic and local hospital.
64 UGNs were detected. The mean CDR was 21.9%. The CDR correlated with UGN detection rate (R = 0.49, p = 0.045). Based on CDR quartiles, operators were divided into group 1 with CDR < 10%, group 2 with CDR 10-17%, group 3 with CDR 17.1-26%, and group 4 with CDR > 26%. Detection rate of UGN was significantly higher in the group 4 in comparison to group 1 (OR 4.4; 95% CI 2.2 - 9.0). In the multivariate regression model, patient age, male gender and operator's CDR > 26% were independent risk factors of UGN detection (OR 1.03; 95% CI 1.01 - 1.05, OR 2; 95% CI 1.2 - 3.5, and OR 5.7 95% CI 1.5 - 22.3, respectively).
The CDR is associated with the detection of upper gastrointestinal neoplasms. This parameter may be a useful quality measure of EGD to be applied in general setting.
食管胃十二指肠镜检查（EGD）是一种常用的诊断方法，但目前尚无被广泛接受的质量衡量标准。我们评估了质量指标综合检出率（CDR），其包含以下至少一种病变的检出：食管入口斑块、胃息肉和溃疡后十二指肠球部变形。本研究的目的是根据上消化道肿瘤（UGN）的检出率来验证 CDR。
这是一项多中心、前瞻性、观察性研究，于 2019 年 1 月至 2019 年 10 月进行。对 2896 例接受诊断性 EGD 的有症状患者的内镜报告进行了分析。EGD 分别在三级大学医院、私立门诊和当地医院的三个内镜科室进行。
共检出 64 例 UGN。平均 CDR 为 21.9%。CDR 与 UGN 检出率相关（R=0.49，p=0.045）。根据 CDR 四分位数，将操作者分为 CDR<10%的第 1 组、CDR 为 10%-17%的第 2 组、CDR 为 17.1%-26%的第 3 组和 CDR>26%的第 4 组。与第 1 组相比，第 4 组 UGN 的检出率明显更高（OR 4.4；95%CI 2.2-9.0）。在多变量回归模型中，患者年龄、男性和操作者的 CDR>26%是 UGN 检出的独立危险因素（OR 1.03；95%CI 1.01-1.05、OR 2；95%CI 1.2-3.5 和 OR 5.7；95%CI 1.5-22.3）。
CDR 与上消化道肿瘤的检出相关。该参数可能是 EGD 在一般情况下的有用质量衡量标准。
