GI Unit Leadership: Shaping a High-Performing Endoscopy Unit (On-Demand) | February 2026-ASGE ACG quality indicators

ASGE ACG quality indicators_capsule and deep enteroscopy

Pdf Summary

This expert panel report establishes comprehensive quality indicators for capsule endoscopy (CE) and deep enteroscopy (DE), procedures critical for diagnosing and managing small-bowel diseases. Although CE and DE are valuable, previous guidelines lacked detailed quality metrics. Using the RAND/UCLA Appropriateness Method, seven gastroenterology experts reviewed literature and clinical experience to develop 13 validated quality indicators each for CE and DE, aimed at preprocedure, intraprocedure, and postprocedure phases.<br /><br />For CE, key preprocedure indicators include competency demonstration (100% target), ensuring CE is performed for appropriate, documented indications (90%), thorough informed consent covering risks like capsule retention (98%), using luminal patency tests before CE in high-risk patients (90%), and timely CE after suspected bleeding (90%). Intraprocedure emphasis includes endoscopic capsule placement for patients with swallowing difficulties (80%). Postprocedure quality focuses on comprehensive photo documentation and transit timing (98%), standardized video reading methods (80%), completeness and mucosal visualization assessment (95%), tracking adverse events (95%), imaging for suspected capsule retention (90%), and generating detailed electronic reports (98%).<br /><br />For DE, preprocedure indicators prioritize demonstrating competency (100%), performance for appropriate indications (90%), review of prior CE or imaging (80%), documented anticoagulation management plan (90%), and appropriate insertion route based on lesion localization (95%). Intraprocedure indicators include timely performance after bleeding episodes (90%), use of carbon dioxide insufflation to improve comfort and insertion depth (90%), estimation of insertion depth (90%), lesion marking when indicated (90%), and accurate characterization and treatment of significant lesions and vascular sources of bleeding (98%). Postprocedure metrics stress comprehensive reporting (98%) and adverse event tracking with management documentation (95%).<br /><br />The report highlights current knowledge gaps and proposes research questions, such as optimal bowel preparation, lesion localization improvements, training standards, and the role of artificial intelligence in CE reading. While outcome measures are ideal, process indicators serve as practical surrogates due to difficulties in routinely measuring long-term results. Adoption of these indicators aims to standardize practice, improve procedure quality, enhance communication, and potentially improve patient outcomes. Future updates will incorporate emerging evidence and technologies.

Keywords

capsule endoscopy

deep enteroscopy

quality indicators

small-bowel diseases

RAND/UCLA Appropriateness Method

preprocedure competency

informed consent

luminal patency test

carbon dioxide insufflation

adverse event tracking