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ASGE ACG quality indicators_capsule and deep enter ...
ASGE ACG quality indicators_capsule and deep enteroscopy
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The document outlines a task force's effort to establish quality indicators for capsule endoscopy (CE) and deep enteroscopy (DE), relatively new medical procedures for diagnosing and treating small-bowel diseases. Understanding that current guidelines lack comprehensive quality measures, the task force aimed to create indicators using the RAND/UCLA Appropriateness Method. An expert panel developed a list of proposed indicators through exhaustive literature review and panel consensus, targeting improvements in quality and patient care. The process resulted in identifying 13 quality indicators for CE and DE across preprocedure, intraprocedure, and postprocedure stages.<br /><br />For CE, these indicators emphasize competencies such as demonstrating proficiency, using standardized methods for video interpretation, and ensuring images' proper documentation. Particular focus is on managing capsule retention and performing procedures promptly after bleeding episodes. The document also calls for enhancing training protocols and suggests research questions on optimizing diagnostic yield and addressing capsule retention issues.<br /><br />For DE, the indicators cover competency demonstration, appropriateness of indications, managing anticoagulation, and the choice of insertion route. Key points include using advanced technologies like carbon dioxide insufflation to improve procedure outcomes and documenting depth of advancement and lesion treatment comprehensively.<br /><br />Both sets of indicators aim to implement structured methodologies to standardize and enhance diagnostic and treatment procedures across various clinical settings. The task force stresses the need for ongoing research to fill existing knowledge gaps, improve technologies, and refine these procedures, potentially enhancing patient outcomes in small-bowel disease management.
Keywords
capsule endoscopy
deep enteroscopy
quality indicators
small-bowel diseases
RAND/UCLA Appropriateness Method
patient care
competency demonstration
diagnostic yield
capsule retention
advanced technologies
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