Development of a REDCap-based tool for quality indicators of endoscopic retrograde cholangiopancreatography assessment

Aims ERCP is one of the endoscopic procedures with the highest complication rates. Performance measurement is very important for ERCP quality improvement. The Endoscopy Department of the Barretos Cancer Hospital (HCB) has a large volume of ERCP procedures. However, there is no tool for evaluating its performance. The aims of this study were to develop and implement a data collection model in REDCap to monitor the quality indicators of ERCP performed at HCB.

Methods Based on the quality indicators proposed by the ASGE, a data collection tool using the REDCap database was built including numerator and denominator measures for each quality indicator ([Fig. 1]).

Fig. 1  

Results Between Jan/2021-May/2022, 170 ERCPs from 137 patients were included in the REDCap, with malignant biliary strictures in 70.8%. Among the priority indicators, the frequencies for the appropriate indication were 100% (ASGE>90%), for the cannulation rate, 91% (ASGE>90%) and success in placing stents in distal stenosis, 100% (ASGE>90%). The stone extraction rate < 10mm was 92% (ASGE>90%). Among the non-priority indicators, the frequency for the use of antibiotic prophylaxis with adequate indication was 9.6% (ASGE>98%). The complication rates were 0% for perforation (ASGE <0.2%) and 2.4% for post-sphincterotomy bleeding (ASGE<1%). The pancreatitis rate was 6% (ASGE: N/A) [1] [2] [3].

Conclusions The REDCap proved to be useful for monitoring quality indicators and most of these indicators reached a satisfactory level, even in a population with a predominance of malignant billiary strictures. The adequate use of antibiotic prophylaxis must be improved.

Conflicts of interest

Authors do not have any conflict of interest to disclose.

• 1 Baron TH, Petersen BT, Mergener K, Chak A, Cohen J, Deal SE. et al. Quality indicators for endoscopic retrograde cholangiopancreatography. Gastrointest Endosc 2006; 63 4 Suppl S29-34
• 2 Cotton PB.. Income and outcome metrics for the objective evaluation of ERCP and alternative methods. Gastrointest Endosc 2002; 56 6 Suppl S283-90
• 3 Adler DG, Lieb JG, Cohen J, Pike IM, Park WG, Rizk MK. et al. Quality indicators for ERCP. Gastrointest Endosc 2015; 81 01 54-66

Publication History

Article published online:
14 April 2023