Updated Quality Indicators for Upper GI Endoscopy | April 2025-Quality indicators for upper GI endoscopy

Quality indicators for upper GI endoscopy

Pdf Summary

The document outlines the quality indicators for upper GI endoscopy (EGD), a procedure used to diagnose and treat conditions of the esophagus, stomach, and duodenum. The American Society for Gastrointestinal Endoscopy and American College of Gastroenterology have defined these indicators in their third iteration since the first document in 2006, updated with new data and indicators.<br /><br />The need for EGD is increasing, with 7.5 million procedures in the United States in 2019, but misuse without appropriate indication is substantial. The guidelines prioritize indicators with significant clinical implications and validated outcomes in clinical studies. They categorize quality indicators into structural, process, and outcome measures to evaluate healthcare environments, care delivery, and results, respectively.<br /><br />A high-quality EGD should be clearly indicated, beneficial for diagnosis or treatment, appropriate, and involve minimal harm. The document incorporates guidelines for each stage of the EGD process—preprocedure, intraprocedure, and postprocedure. Preprocedure indicators include appropriate procedure indication, informed consent, and sedation plan documentation. Intraprocedure indicators emphasize photodocumentation, esophageal biopsy sampling, and the use of modern imaging techniques for Barrett's esophagus. Postprocedure indicators focus on recommendations related to the management of esophageal and gastric conditions post-EGD, such as follow-up surveillance for Barrett’s Esophagus or gastric ulcers.<br /><br />Specific standards are established, like a 95% target for performing EGD with documented indications, and the application of benchmarks such as these can guide quality improvement efforts. The focus is on areas with substantial variance in care to encourage consistent high-quality practice across facilities and practitioners.<br /><br />Overall, these quality indicators aim to enhance the safety, effectiveness, and appropriateness of EGD by providing benchmarks for clinical practice. The document also highlights the potential for future developments, such as the application of artificial intelligence and deep learning in endoscopy.

Keywords

upper GI endoscopy

quality indicators

American Society for Gastrointestinal Endoscopy

American College of Gastroenterology

EGD guidelines

clinical implications

structural measures

process measures

outcome measures

artificial intelligence in endoscopy