Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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Quality indicators in esophagogastroduodenoscopy

  • Sang Yoon Kim (Department of Internal Medicine, Myongji Hospital, Hanyang University College of Medicine) ;
  • Jae Myung Park (Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea)
  • Received : 2022.03.09
  • Accepted : 2022.04.22
  • Published : 2022.05.30
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Abstract

Esophagogastroduodenoscopy (EGD) has been used to diagnose a wide variety of upper gastrointestinal diseases. In particular, EGD is used to screen high-risk subjects of gastric cancer. Quality control of EGD is important because the diagnostic rate is examiner-dependent. However, there is still no representative quality indicator that can be uniformly applied in EGD. There has been growing awareness of the importance of quality control in improving EGD performance. Therefore, we aimed to review the available and emerging quality indicators for diagnostic EGD.

Keywords

Acknowledgement

This research was supported by the Basic Science Research Program through the National Research Foundation of Korea, funded by the Ministry of Education, Science, and Technology (2019R1A5A2027588 and 2020R1F1A1076448).

References

  1. Hamashima C, Ogoshi K, Narisawa R, et al. Impact of endoscopic screening on mortality reduction from gastric cancer. World J Gastroenterol 2015;21:2460-2466.
  2. Cohen J, Safdi MA, Deal SE, et al. Quality indicators for esophagogastroduodenoscopy. Am J Gastroenterol 2006;101:886-891.
  3. Park WG, Shaheen NJ, Cohen J, et al. Quality indicators for EGD. Gastrointest Endosc 2015;81:17-30.
  4. Park CH, Kim B, Chung H, et al. Endoscopic quality indicators for esophagogastroduodenoscopy in gastric cancer screening. Dig Dis Sci 2015;60:38-46.
  5. Beg S, Ragunath K, Wyman A, et al. Quality standards in upper gastrointestinal endoscopy: a position statement of the British Society of Gastroenterology (BSG) and Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland (AUGIS). Gut 2017;66:1886-1899.
  6. Min JK, Cha JM, Cho YK, et al. Revision of quality indicators for the endoscopy quality improvement program of the National Cancer Screening Program in Korea. Clin Endosc 2018;51:239-252.
  7. Chiu PWY, Uedo N, Singh R, et al. An Asian consensus on standards of diagnostic upper endoscopy for neoplasia. Gut 2019;68:186-197.
  8. Bisschops R, Areia M, Coron E, et al. Performance measures for upper gastrointestinal endoscopy: a European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative. Endoscopy 2016;48:843-864.
  9. Kaminski MF, Regula J, Kraszewska E, et al. Quality indicators for colonoscopy and the risk of interval cancer. N Engl J Med 2010;362:1795-1803.
  10. Keswani RN, Crockett SD, Calderwood AH. AGA clinical practice update on strategies to improve quality of screening and surveillance colonoscopy: expert review. Gastroenterology 2021;161:701-711.
  11. Barclay RL, Vicari JJ, Doughty AS, et al. Colonoscopic withdrawal times and adenoma detection during screening colonoscopy. N Engl J Med 2006;355:2533-2541.
  12. Rex DK, Schoenfeld PS, Cohen J, et al. Quality indicators for colonoscopy. Gastrointest Endosc 2015;81:31-53.
  13. Meining A, Riedl B, Stolte M. Features of gastritis predisposing to gastric adenoma and early gastric cancer. J Clin Pathol 2002;55:770-773.
  14. East JE, Vieth M, Rex DK. Serrated lesions in colorectal cancer screening: detection, resection, pathology and surveillance. Gut 2015; 64:991-1000.
  15. Ren W, Yu J, Zhang ZM, et al. Missed diagnosis of early gastric cancer or high-grade intraepithelial neoplasia. World J Gastroenterol 2013;19:2092-2096.
  16. Chadwick G, Groene O, Hoare J, et al. A population-based, retrospective, cohort study of esophageal cancer missed at endoscopy. Endoscopy 2014;46:553-560.
  17. Pimenta-Melo AR, Monteiro-Soares M, Libanio D, et al. Missing rate for gastric cancer during upper gastrointestinal endoscopy: a systematic review and meta-analysis. Eur J Gastroenterol Hepatol 2016;28:1041-1049.
  18. Beck M, Bringeland EA, Qvigstad G, et al. Gastric cancers missed at upper endoscopy in Central Norway 2007 to 2016: a population-based study. Cancers (Basel) 2021;13:5628.
  19. Uedo N, Gotoda T, Yoshinaga S, et al. Differences in routine esophagogastroduodenoscopy between Japanese and international facilities: a questionnaire survey. Dig Endosc 2016;28 Suppl 1:16-24.
  20. Harewood GC, Sharma VK, de Garmo P. Impact of colonoscopy preparation quality on detection of suspected colonic neoplasia. Gastrointest Endosc 2003;58:76-79.
  21. Neale JR, James S, Callaghan J, et al. Premedication with N-acetylcysteine and simethicone improves mucosal visualization during gastroscopy: a randomized, controlled, endoscopist-blinded study. Eur J Gastroenterol Hepatol 2013;25:778-783.
  22. Lee GJ, Park SJ, Kim SJ, et al. Effectiveness of premedication with pronase for visualization of the mucosa during endoscopy: a randomized, controlled trial. Clin Endosc 2012;45:161-164.
  23. Liu X, Guan CT, Xue LY, et al. Effect of premedication on lesion detection rate and visualization of the mucosa during upper gastrointestinal endoscopy: a multicenter large sample randomized controlled double-blind study. Surg Endosc 2018;32:3548-3556.
  24. Chang WK, Yeh MK, Hsu HC, et al. Efficacy of simethicone and N-acetylcysteine as premedication in improving visibility during upper endoscopy. J Gastroenterol Hepatol 2014;29:769-774.
  25. Zhang Q, Chen ZY, Chen CD, et al. Training in early gastric cancer diagnosis improves the detection rate of early gastric cancer: an observational study in China. Medicine (Baltimore) 2015;94:e384.
  26. Kim SY, Park JM, Cho HS, et al. Assessment of cimetropium bromide use for the detection of gastric neoplasms during esophagogastroduodenoscopy. JAMA Netw Open 2022;5:e223827.
  27. Omata F, Kumakura Y, Ishii N, et al. Noneffectiveness of scopolamine for facilitating detection of upper gastrointestinal neoplasia during screening esophagogastroduodenoscopy: propensity score-matched study. Endoscopy 2020;52:556-562.
  28. Cohen LB, Wecsler JS, Gaetano JN, et al. Endoscopic sedation in the United States: results from a nationwide survey. Am J Gastroenterol 2006;101:967-974.
  29. McQuaid KR, Laine L. A systematic review and meta-analysis of randomized, controlled trials of moderate sedation for routine endoscopic procedures. Gastrointest Endosc 2008;67:910-923.
  30. Bell GD, Quine A. Preparation, premedication, and surveillance. Endoscopy 2006;38:105-109.
  31. Fanti L, Testoni PA. Sedation and analgesia in gastrointestinal endoscopy: what's new? World J Gastroenterol 2010;16:2451-2457.
  32. Zhou J, Li Z, Ji R, et al. Influence of sedation on the detection rate of early cancer and precancerous lesions during diagnostic upper gastrointestinal endoscopies: a multicenter retrospective study. Am J Gastroenterol 2021;116:1230-1237.
  33. Yao K. The endoscopic diagnosis of early gastric cancer. Ann Gastroenterol 2013;26:11-22.
  34. Lee JI, Kim JS, Kim BW, et al. Taking more gastroscopy images increases the detection rate of clinically significant gastric lesions: validation of a systematic screening protocol for the stomach. Korean J Helicobacter Up Gastrointest Res 2020;20:225-232.
  35. Park JM, Lim CH, Cho YK, et al. The effect of photo-documentation of the ampulla on neoplasm detection rate during esophagogastroduodenoscopy. Endoscopy 2019;51:115-124.
  36. Armstrong D, Bennett JR, Blum AL, et al. The endoscopic assessment of esophagitis: a progress report on observer agreement. Gastroenterology 1996;111:85-92.
  37. Alvarez Herrero L, Curvers WL, van Vilsteren FG, et al. Validation of the Prague C&M classification of Barrett's esophagus in clinical practice. Endoscopy 2013;45:876-882.
  38. Forrest JA, Finlayson ND, Shearman DJ. Endoscopy in gastrointestinal bleeding. Lancet 1974;2:394-397.
  39. Endoscopic Classification Review Group. Update on the Paris classification of superficial neoplastic lesions in the digestive tract. Endoscopy 2005;37:570-578.
  40. Hirano I, Moy N, Heckman MG, et al. Endoscopic assessment of the oesophageal features of eosinophilic oesophagitis: validation of a novel classification and grading system. Gut 2013;62:489-495.
  41. Cheng HT, Cheng CL, Lin CH, et al. Caustic ingestion in adults: the role of endoscopic classification in predicting outcome. BMC Gastroenterol 2008;8:31.
  42. de Franchis R; Baveno VI Faculty. Expanding consensus in portal hypertension: report of the Baveno VI Consensus Workshop: stratifying risk and individualizing care for portal hypertension. J Hepatol 2015;63:743-752.
  43. Kahrilas PJ, Kim HC, Pandolfino JE. Approaches to the diagnosis and grading of hiatal hernia. Best Pract Res Clin Gastroenterol 2008;22:601-616.
  44. Spigelman AD, Williams CB, Talbot IC, et al. Upper gastrointestinal cancer in patients with familial adenomatous polyposis. Lancet 1989;2:783-785.
  45. Gupta N, Gaddam S, Wani SB, et al. Longer inspection time is associated with increased detection of high-grade dysplasia and esophageal adenocarcinoma in Barrett's esophagus. Gastrointest Endosc 2012;76:531-538.
  46. Teh JL, Tan JR, Lau LJ, et al. Longer examination time improves detection of gastric cancer during diagnostic upper gastrointestinal endoscopy. Clin Gastroenterol Hepatol 2015;13:480-487.
  47. Kawamura T, Wada H, Sakiyama N, et al. Examination time as a quality indicator of screening upper gastrointestinal endoscopy for asymptomatic examinees. Dig Endosc 2017;29:569-575.
  48. Park JM, Huo SM, Lee HH, et al. Longer observation time increases proportion of neoplasms detected by esophagogastroduodenoscopy. Gastroenterology 2017;153:460-469.
  49. Park JM, Kim SY, Shin GY, et al. Implementation effect of institutional policy of EGD observation time on neoplasm detection. Gastrointest Endosc 2021;93:1152-1159.
  50. Lee HH, Park JM, Lim CH, et al. The impact of pre-resection endoscopic examination time on the rate of synchronous gastric neoplasms missed during endoscopic treatment. Surg Endosc 2017;31:3952-3960.
  51. Choi Y, Choi HS, Jeon WK, et al. Optimal number of endoscopic biopsies in diagnosis of advanced gastric and colorectal cancer. J Korean Med Sci 2012;27:36-39.
  52. Hatfield AR, Slavin G, Segal AW, et al. Importance of the site of endoscopic gastric biopsy in ulcerating lesions of the stomach. Gut 1975;16:884-886.
  53. Pimentel-Nunes P, Libanio D, Marcos-Pinto R, et al. Management of epithelial precancerous conditions and lesions in the stomach (MAPS II): European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter and Microbiota Study Group (EHMSG), European Society of Pathology (ESP), and Sociedade Portuguesa de Endoscopia Digestiva (SPED) guideline update 2019. Endoscopy 2019;51:365-388.
  54. Januszewicz W, Wieszczy P, Bialek A, et al. Endoscopist biopsy rate as a quality indicator for outpatient gastroscopy: a multicenter cohort study with validation. Gastrointest Endosc 2019;89:1141-1149.
  55. Lee HS, Jeon SW. Barrett esophagus in Asia: same disease with different pattern. Clin Endosc 2014;47:15-22.
  56. Rex DK, Shaw M, Wong R. Prevalence of Barrett's esophagus. Gastroenterology 2006;130:1373-1374.
  57. Levine DS. Management of dysplasia in the columnar-lined esophagus. Gastroenterol Clin North Am 1997;26:613-634.
  58. Dixon MF, Genta RM, Yardley JH, et al. Classification and grading of gastritis: the updated Sydney System. International Workshop on the Histopathology of Gastritis, Houston 1994. Am J Surg Pathol 1996;20:1161-1181.
  59. Yue H, Shan L, Bin L. The significance of OLGA and OLGIM staging systems in the risk assessment of gastric cancer: a systematic review and meta-analysis. Gastric Cancer 2018;21:579-587.
  60. Yamazato T, Oyama T, Yoshida T, et al. Two years' intensive training in endoscopic diagnosis facilitates detection of early gastric cancer. Intern Med 2012;51:1461-1465.
  61. Korean Society of Gastrointestinal Endoscopy. Quality Control E-learning [Internet]. Seoul; 2020 [cited 2022 Mar 9]. Available from: https://www.gie.or.kr/disinfect/Elearning.php.
  62. National Cancer Center. National Cancer Screening Quality Improvement Online Education Program [Internet]. Goyang; 2013 [cited 2022 Mar 9]. Available from: https://neweducation.ncc.re.kr/#.
  63. Lee W. Application of current image-enhanced endoscopy in gastric diseases. Clin Endosc 2021;54:477-487.
  64. Mabe K, Yao K, Nojima M, et al. An educational intervention to improve the endoscopist's ability to correctly diagnose small gastric lesions using magnifying endoscopy with narrow-band imaging. Ann Gastroenterol 2014;27:149-155.
  65. Yang YJ, Bang CS. Application of artificial intelligence in gastroenterology. World J Gastroenterol 2019;25:1666-1683.
  66. Wu L, He X, Liu M, et al. Evaluation of the effects of an artificial intelligence system on endoscopy quality and preliminary testing of its performance in detecting early gastric cancer: a randomized controlled trial. Endoscopy 2021;53:1199-1207.
  67. Kuo CY, Chiu HM. Application of artificial intelligence in gastroenterology: potential role in clinical practice. J Gastroenterol Hepatol 2021;36:267-272.
  68. Bang CS, Lee JJ, Baik GH. Computer-aided diagnosis of esophageal cancer and neoplasms in endoscopic images: a systematic review and meta-analysis of diagnostic test accuracy. Gastrointest Endosc 2021;93:1006-1015.
  69. Choi SJ, Khan MA, Choi HS, et al. Development of artificial intelligence system for quality control of photo documentation in esophagogastroduodenoscopy. Surg Endosc 2022;36:57-65.
  70. Wu L, Zhang J, Zhou W, et al. Randomised controlled trial of WISENSE, a real-time quality improving system for monitoring blind spots during esophagogastroduodenoscopy. Gut 2019;68:2161-2169.
  71. Hirasawa T, Aoyama K, Tanimoto T, et al. Application of artificial intelligence using a convolutional neural network for detecting gastric cancer in endoscopic images. Gastric Cancer 2018;21:653-660.
  72. Menon S, Trudgill N. How commonly is upper gastrointestinal cancer missed at endoscopy? a meta-analysis. Endosc Int Open 2014;2:E46-E50.
  73. Yalamarthi S, Witherspoon P, McCole D, et al. Missed diagnoses in patients with upper gastrointestinal cancers. Endoscopy 2004;36:874-879.
  74. Chen D, Wu L, Li Y, et al. Comparing blind spots of unsedated ultrafine, sedated, and unsedated conventional gastroscopy with and without artificial intelligence: a prospective, single-blind, 3-parallel-group, randomized, single-center trial. Gastrointest Endosc 2020;91:332-339.
  75. Berzin TM, Parasa S, Wallace MB, et al. Position statement on priorities for artificial intelligence in GI endoscopy: a report by the ASGE Task Force. Gastrointest Endosc 2020;92:951-959.
  76. Sano T, Coit DG, Kim HH, et al. Proposal of a new stage grouping of gastric cancer for TNM classification: International Gastric Cancer Association staging project. Gastric Cancer 2017;20:217-225.
  77. Isomoto H, Shikuwa S, Yamaguchi N, et al. Endoscopic submucosal dissection for early gastric cancer: a large-scale feasibility study. Gut 2009;58:331-336.