Abstract:
BACKGROUND AND AIMS:The cecal intubation rate (CIR) is a widely accepted key performance indicator (KPI) in colonoscopy but lacks a universal calculation method. We aimed to assess whether differences in CIR calculation methods could have an impact on perceived trainee outcomes. METHODS:A systematic review of CIR calculation methods was conducted on major societal guidelines (United Kingdom, European Society of Gastrointestinal Endoscopy [ESGE] and American Society for Gastrointestinal Endoscopy [ASGE]) and trainee-inclusive studies. Trainees awarded colonoscopy certification between June 2011 and 2016 were identified from the United Kingdom e-portfolio and selected as a validation cohort. For each trainee, both the crude and unassisted CIR were calculated for 50 post-certification procedures using definitions from the 3 international guidelines. The resulting CIRs, and the proportions of endoscopists failing to meet the minimum standard of CIR ≥90%, were then compared across these definitions. RESULTS:Across the 3 guidelines and 37 eligible studies identified, differences in CIR calculation methodology were demonstrated. These related to adjustment criteria (18 studies) and whether unassisted CIR was stipulated (18 studies). In the validation cohort of 733 trainees (36,650 procedures), the median crude CIR ranged from 96% (ESGE) to 98% (ASGE) (P < .001) and whether unassisted CIR was specified (ESGE, 94%; ASGE, 96%; P < .001). The proportion of trainees failing to achieve CIR ≥90% varied significantly across the different definitions, from 4.9% for the crude ASGE definition to 18.6% for the unassisted ESGE definition (P < .001). CONCLUSIONS:CIR calculation methods vary among guidelines and research studies; this has an impact on trainee performance measures. With CIR used as an example, this study highlights the need for standardized definitions and calculations of KPIs in endoscopy.
journal_name
Gastrointest Endoscjournal_title
Gastrointestinal endoscopyauthors
Siau K,Hodson J,Ravindran S,Rutter MD,Iacucci M,Dunckley Pdoi
10.1016/j.gie.2018.12.026subject
Has Abstractpub_date
2019-05-01 00:00:00pages
1026-1036.e2issue
5eissn
0016-5107issn
1097-6779pii
S0016-5107(19)30014-8journal_volume
89pub_type
杂志文章,meta分析abstract:BACKGROUND AND AIMS:Digital cholangioscopes provide higher-resolution imaging of the pancreatobiliary tract compared with fiberoptic instruments. The role of a new, digital, single-operator cholangiopancreatoscopy (SOC) system for diagnosis and treatment of pancreatobiliary disorders in clinical practice is not known. ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,多中心研究
doi:10.1016/j.gie.2016.03.789
更新日期:2016-10-01 00:00:00
abstract::Forceful dilation of the lower esophageal sphincter is considered primary therapy for achalasia. The Witzel pneumatic balloon dilator, unlike fluoroscopically placed dilators, is placed over a standard gastroscope allowing positioning and dilation under direct vision. We report our experience with the Witzel dilator i...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(90)71120-0
更新日期:1990-09-01 00:00:00
abstract:BACKGROUND:We sought to determine the histologic effects of metal stent placement on tumor tissue and on normal tissue proximal and distal to the tumor in patients with expandable metal stents implanted in vivo. METHODS:Twelve patients with 10 to 16 mm uncovered Wallstents were studied, 5 with esophageal stents, 4 wit...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(96)70198-0
更新日期:1996-06-01 00:00:00
abstract:BACKGROUND:The diagnostic utility of EUS-guided FNA (EUS-FNA) and EUS-guided Trucut biopsy (EUS-TCB) of pelvic masses has not been well described. OBJECTIVE:To evaluate the utility of EUS in the diagnosis of pelvic masses. DESIGN:Retrospective cohort study. SETTING:Single tertiary referral hospital in Indianapolis, ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2011.08.031
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Wireless capsule endoscopy (CE) is the investigation of choice in obscure GI bleeding (OGIB), with a high diagnostic yield when compared with other modalities. It enables specific treatment to be instigated in a significant proportion of cases, with the aim of reducing rebleeding rates. Little evidence is cu...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2008.06.054
更新日期:2008-12-01 00:00:00
abstract:BACKGROUND:The rate of spontaneous migration of bile duct stones through the duodenal papilla is not well known. Endoscopic retrograde cholangiography (ERC) has been the standard method to diagnose bile duct stones, but accumulating data show there is a good agreement between ERC and endoscopic ultrasonography (EUS). T...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(00)70414-7
更新日期:2000-02-01 00:00:00
abstract:BACKGROUND:Endoscopic resection of large colorectal lesions is associated with high complication rates. OBJECTIVE:To evaluate the effect of prophylactic clip closure of polypectomy sites after resection of large (≥2 cm) sessile and flat colorectal lesions. DESIGN:Retrospective study. SETTING:Tertiary referral center...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2012.10.024
更新日期:2013-03-01 00:00:00
abstract:BACKGROUND:Patients with malignant esophagorespiratory fistulas have a poor prognosis. Treatment is palliative and involves restoration of the ability to ingest food and prevention of aspiration by insertion of esophageal or tracheobronchial stents. Because insertion of a single stent may be insufficient for palliation...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1067/mge.2002.119731
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND AND AIMS:Blue-light imaging (BLI) is a new chromoendoscopy technique, potentially useful for differentiating neoplastic from nonneoplastic lesions. The present study was aimed at comparing BLI with high-definition white light (HDWL) in the real-time histology prediction of colon polyps <10 mm. METHODS:Conse...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.gie.2018.09.027
更新日期:2019-03-01 00:00:00
abstract::Disposable plastic biopsy forceps were compared prospectively to reusable stainless steel forceps. Thirty consecutive patients underwent a total of 249 biopsies, 124 with the disposable forceps, and 125 with reusable forceps. Biopsy locations included the esophagus, stomach, small intestine, colon, and common bile duc...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章
doi:10.1016/s0016-5107(90)71069-3
更新日期:1990-07-01 00:00:00
abstract:BACKGROUND AND AIMS:Proctocolectomy prevents colorectal cancer in familial adenomatous polyposis (FAP). Colorectal polyp progression is one of the indications for surgery. No data exist regarding the natural history of colorectal polyposis in young patients with FAP. This study examined the rate of polyposis progressio...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2018.05.021
更新日期:2018-10-01 00:00:00
abstract::Endoscopic ultrasonography was performed in 25 patients with suspected pancreatic disease. Cancer of the pancreas was recognized in 9 of 10 cases with 1 false negative and 2 false positive diagnoses. Chronic pancreatitis was recognized in 89% of cases. Technical difficulties limited the success of the examination in 2...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(89)72761-9
更新日期:1989-05-01 00:00:00
abstract:BACKGROUND:Appropriate management of lower-GI hemorrhage remains controversial largely because outcomes data are lacking. It is our hypothesis that clinical factors, such as comorbidity, hemodynamic instability, and timing of colonoscopy, are associated with hospital lengths of stay. METHODS:Medical records of patient...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(03)02304-6
更新日期:2003-12-01 00:00:00
abstract:BACKGROUND AND AIMS:The American Society for Gastrointestinal Endoscopy recommends prophylactic pancreatic duct stent placement (PPS) and rectal nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce the incidence and severity of post-ERCP pancreatitis (PEP) in high-risk individuals and suggests that rectal indomethac...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2019.11.013
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND:The endoscopic measurement of sphincter of Oddi pressure is a technically difficult procedure requiring significant expertise. Intrabiliary pressure is technically easy to measure. Furthermore, since it is believed that the pathogenesis of pain in patients with sphincter of Oddi dysfunction is attributable t...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(96)70054-8
更新日期:1996-12-01 00:00:00
abstract:BACKGROUND:Many options are available for palliation of inoperable malignant stenoses of the esophagus. We report our experience with different modalities of endoscopic therapy. METHODS:From 1986 to 1996, we treated 125 patients with dysphagia caused by unresectable malignant tumors with endoscopic therapy. Seventy pa...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(98)70007-0
更新日期:1998-10-01 00:00:00
abstract:BACKGROUND:Placement of a pancreatic duct (PD) stent reduces post-ERCP pancreatitis rates in high-risk patients. Patients with suspected sphincter of Oddi dysfunction (SOD) who are found to have normal manometry results (SOM) are also at high risk for this complication. OBJECTIVE:Our purpose was to determine whether P...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2007.06.022
更新日期:2008-02-01 00:00:00
abstract:BACKGROUND:Hands-on endoscopy workshops are popular and valuable sources for the continuing medical education of endoscopists. Concerns, however, exist regarding clinical outcomes of procedures performed during hands-on training of ERCP. OBJECTIVE:We compared the success rates and complications between patients in the...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,多中心研究
doi:10.1016/j.gie.2008.05.029
更新日期:2009-02-01 00:00:00
abstract:BACKGROUND:It is now accepted that the curing of Helicobacter pylori infection will result in healing of chronic active gastritis and will change the natural history of gastroduodenal ulcer disease. Both endoscopic observation and evaluation of H. pylori status of the stomach are necessary for diagnosis and treatment o...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章
doi:10.1016/s0016-5107(99)70442-6
更新日期:1999-01-01 00:00:00
abstract::One hundred colonoscopies were done. The colonoscopist noted whether the cecum had been intubated as well as the markers used to make this determination. With the colonoscope in position at maximum penetration, a radiologist independently determined its position using fluoroscopy, with a contrast agent delivered throu...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(92)70516-1
更新日期:1992-09-01 00:00:00
abstract:BACKGROUND:Enteral feeding by percutaneous endoscopic gastrostomy is indicated as long-term nutritional support for children with neurologic impairment and dysphagia. We report our experience with percutaneous endoscopic gastrostomy and evaluate the age range of children with cerebral palsy who benefit most with weight...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(99)70222-1
更新日期:1999-08-01 00:00:00
abstract:BACKGROUND:Although conventional endoscopy is a good diagnostic tool to evaluate tumor depth (T staging) in early gastric cancer (EGC), its accuracy has not been determined and no consensus has been reached regarding standard endoscopic criteria. OBJECTIVE:To evaluate the diagnostic accuracy of endoscopic T staging an...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2010.11.053
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND:Lymphangiohemangioma, also called lymphatic-venous or venolymphatic malformation, is a rare malformation of the lymphatics, with vascular elements. These are low-flow vascular lesions. OBJECTIVE:To evaluate the feasibility and efficacy of endoscopic injection sclerotherapy with doxycycline for low-flow vasc...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2007.06.023
更新日期:2007-12-01 00:00:00
abstract:BACKGROUND:Unsedated endoscopy has not gained wide acceptance in the United States. Factors that may predict tolerance and acceptance of unsedated endoscopy are ill defined. METHODS:Outpatients referred for standard EGD were recruited to undergo unsedated ultrathin esophagoscopy (UUE) with a new 3.1-mm battery-powered...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1067/mge.2002.123274
更新日期:2002-05-01 00:00:00
abstract:BACKGROUND:Radiation proctitis is a complication of radiotherapy for malignant pelvic disease. Argon beam coagulation is a new and rapidly evolving technology that permits a "no-touch" electrocoagulation of diseased tissue. METHODS:We analyzed retrospectively the records of 7 patients with prostatic and endometrial ca...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(99)70054-4
更新日期:1999-04-01 00:00:00
abstract:BACKGROUND:Appropriateness of indications is essential to the rational utilization of resources. The aim of this study was to evaluate the appropriate use of colonoscopy in an open access system and to assess whether the American Society for Gastrointestinal Endoscopy (ASGE) guidelines are useful in clinical practice. ...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1067/mge.2000.106683
更新日期:2000-07-01 00:00:00
abstract:BACKGROUND:A trucut needle biopsy device that can be used to obtain specimens from the pancreas and other perigastric organs under EUS guidance has been developed and successfully tested in animals. Moreover, EUS-guided trucut needle biopsy has been used safely in humans and appears to provide more accurate results tha...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(03)02538-0
更新日期:2004-02-01 00:00:00
abstract:BACKGROUND:Little is known about gastric neoplasms arising from hyperplastic polyps (HPs). OBJECTIVE:To investigate the risk factors associated with neoplasms within HPs and to evaluate the role of alterations of the p16-cyclin D1-pRb pathway in the malignant transformation of HPs. DESIGN:Retrospective, case-control ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2014.04.020
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:The cornerstone of management for acute cholecystitis is cholecystectomy. However, surgical intervention is contraindicated in the occasional patient. EUS-guided transduodenal gallbladder drainage may represent an effective minimally invasive alternative. OBJECTIVES:To describe a new technique, EUS-guided c...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2007.02.065
更新日期:2007-09-01 00:00:00
abstract::A technique for expeditious and safe placement of nasoenteric feeding tubes under direct vision is described. Adult patients undergo feeding tube placement with intravenous sedation and topical anesthesia. Endoscopic tube placement requires an average of 10 min and eliminates many risks associated with blind passage. ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(86)71882-8
更新日期:1986-10-01 00:00:00