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Quality indicators for capsule endoscopy and deep enteroscopy

Pdf Summary

The document discusses the development of quality indicators for capsule endoscopy (CE) and deep enteroscopy (DE), two procedures used to diagnose and treat small-bowel diseases. Despite existing guidelines for using CE and DE, comprehensive quality indicators have been lacking. The document details the efforts of a task force of seven expert gastroenterologists to establish these indicators using the RAND/UCLA Appropriateness Method, aiming to improve patient care and procedure outcomes.<br /><br />The panel identified 13 key quality indicators for CE and DE. These indicators are categorized into pre-procedure, intra-procedure, and post-procedure measures, each with specified performance targets, such as:<br />- Demonstrating competency in both CE and DE with a performance target of 100%.<br />- Performing CE for documented indications with a target of 90%.<br />- Utilizing a luminal patency test before CE in high-risk patients with a target of 90%.<br /><br />For CE, the document emphasizes the necessity of timely procedures, photo documentation, management recommendations based on findings, and the tracking of adverse events. For DE, additional focus areas include the appropriate response to immediate bleeding events, the use of carbon dioxide for insufflation, and the need for assessment and marking of advancements during procedures.<br /><br />These indicators are designed to assess structural, process, and outcome measures, ultimately aiming to enhance the quality of care. Key research questions and challenges were also identified to guide future investigation and quality improvements in these procedures.<br /><br />The document concludes that the newly established indicators will need regular updates as technologies and practices evolve, ensuring that they continue to improve CE and DE performance and standards in clinical practice.

Keywords

capsule endoscopy

deep enteroscopy

quality indicators

small-bowel diseases

gastroenterologists

RAND/UCLA Appropriateness Method

patient care

procedure outcomes

performance targets

clinical practice