The European Society of Gastrointestinal Endoscopy Quality Improvement Initiative: developing performance measures

Matthew D. Rutter; Carlo Senore; Raf Bisschops; Dirk Domagk; Roland Valori; Michal F. Kaminski; Cristiano Spada; Michael Bretthauer; Cathy Bennett; Cristina Bellisario; Silvia Minozzi; Cesare Hassan; Colin Rees; Mário Dinis-Ribeiro; Tomas Hucl; Thierry Ponchon; Lars Aabakken; Paul Fockens

doi:10.1055/s-0035-1569580

Endoscopy, Table of Contents

Endoscopy 2016; 48(01): 81-89
DOI: 10.1055/s-0035-1569580

Guideline

The European Society of Gastrointestinal Endoscopy Quality Improvement Initiative: developing performance measures

Matthew D. Rutter

¹Department of Gastroenterology, University Hospital of North Tees, Stockton-on-Tees, Cleveland, UK

²School of Medicine, Durham University, UK

,

Carlo Senore

³CPO Piemonte, AOU Città della Salute e della Scienza, Torino, Italy

,

Raf Bisschops

⁴Gastroenterology Department, University Hospital Leuven, Leuven, Belgium

,

Dirk Domagk

⁵Department of Medicine I, Josephs-Hospital Warendorf, Academic Teaching Hospital, University of Münster, Warendorf, Germany

,

Roland Valori

⁶Department of Gastroenterology, Gloucestershire Royal Hospital, Gloucester, UK

,

Michal F. Kaminski

⁷Department of Gastroenterological Oncology, The Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, and Medical Center for Postgraduate Education, Warsaw, Poland

⁸Department of Health Management and Health Economics, University of Oslo, Oslo, Norway

,

Cristiano Spada

⁹Digestive Endoscopy Unit, Catholic University, Rome, Italy

,

Michael Bretthauer

⁸Department of Health Management and Health Economics, University of Oslo, Oslo, Norway

¹⁰Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway

¹¹K.G. Jebsen Colorectal Cancer Research Centre, University of Oslo, Oslo, Norway

,

Cathy Bennett

¹²Centre for Technology Enabled Research, Faculty of Health and Life Sciences, Coventry University, Coventry, UK

,

Cristina Bellisario

³CPO Piemonte, AOU Città della Salute e della Scienza, Torino, Italy

,

Silvia Minozzi

³CPO Piemonte, AOU Città della Salute e della Scienza, Torino, Italy

,

Cesare Hassan

¹³Nuovo Regina Margherita Hospital, Rome, Italy

,

Colin Rees

¹Department of Gastroenterology, University Hospital of North Tees, Stockton-on-Tees, Cleveland, UK

,

Mário Dinis-Ribeiro

¹⁴Servicio de Gastroenterologia, Instituto Portugues de Oncologia Francisco Gentil, Porto, Portugal

,

Tomas Hucl

¹⁵Department of Gastroenterology and Hepatology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic

,

Thierry Ponchon

¹⁶Department. of Digestive Diseases, Hôpital Edouard Herriot, Lyon, France

,

Lars Aabakken

¹⁰Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway

,

Paul Fockens

¹⁷Department of Gastroenterology and Hepatology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands

› Author Affiliations

Abstract

The European Society of Gastrointestinal Endoscopy (ESGE) and United European Gastroenterology (UEG) have a vision to create a thriving community of endoscopy services across Europe, collaborating with each other to provide high quality, safe, accurate, patient-centered and accessible endoscopic care. Whilst the boundaries of what can be achieved by advanced endoscopy are continually expanding, we believe that one of the most fundamental steps to achieving our goal is to raise the quality of everyday endoscopy. The development of robust, consensus- and evidence-based key performance measures is the first step in this vision.

ESGE and UEG have identified quality of endoscopy as a major priority. This paper explains the rationale behind the ESGE Quality Improvement Initiative and describes the processes that were followed. We recommend that all units develop mechanisms for audit and feedback of endoscopist and service performance using the ESGE performance measures that will be published in future issues of this journal over the next year. We urge all endoscopists and endoscopy services to prioritize quality and to ensure that these performance measures are implemented and monitored at a local level, so that we can provide the highest possible care for our patients.

Full Text

References

References
1 Rutter MD, Rees CJ. Quality in gastrointestinal endoscopy. Endoscopy 2014; 46: 526-528
2 Rajasekhar P, Rutter M, Bramble M et al. Achieving high quality colonoscopy: Using graphical representation to measure performance and reset standards. Colorectal Dis 2012; 14: 1538-1545
3 Baillie J, Testoni PA. Are we meeting the standards set for ERCP?. Gut 2007; 56: 744-746
4 Cotton PB. Are low-volume ERCPists a problem in the United States? A plea to examine and improve ERCP practice – NOW. Gastrointest Endosc 2011; 74: 161-166
5 Williams EJ, Taylor S, Fairclough P et al. Risk factors for complication following ERCP; results of a large-scale, prospective multicenter study. Endoscopy 2007; 39: 793-801
6 Williams EJ, Taylor S, Fairclough P et al. Are we meeting the standards set for endoscopy? Results of a large-scale prospective survey of endoscopic retrograde cholangio-pancreatograph practice. Gut 2007; 56: 821-829
7 Pabby A, Schoen RE, Weissfeld JL et al. Analysis of colorectal cancer occurrence during surveillance colonoscopy in the dietary Polyp Prevention Trial. Gastrointest Endosc 2005; 61: 385-391
8 Robertson DJ, Lieberman DA, Winawer SJ et al. Colorectal cancers soon after colonoscopy: a pooled multicohort analysis. Gut 2014; 63: 949-956
9 van Rijn JC, Reitsma JB, Stoker J et al. Polyp miss rate determined by tandem colonoscopy: a systematic review. Am J Gastroenterol 2006; 101: 343-350
10 Van Gelder RE, Nio CY, Florie J et al. Computed tomographic colonography compared with colonoscopy in patients at increased risk for colorectal cancer. Gastroenterology 2004; 127: 41-48
11 Pickhardt PJ, Choi JR, Hwang I et al. Computed tomographic virtual colonoscopy to screen for colorectal neoplasia in asymptomatic adults. N Engl J Med 2003; 349: 2191-2200
12 Rockey DC, Paulson E, Niedzwiecki D et al. Analysis of air contrast barium enema, computed tomographic colonography, and colonoscopy: prospective comparison. Lancet 2005; 365: 305-311
13 Miller RE, Lehman G. Polypoid colonic lesions undetected by endoscopy. Radiology 1978; 129: 295-297
14 Pickhardt PJ, Nugent PA, Mysliwiec PA et al. Location of adenomas missed by optical colonoscopy. Ann Intern Med 2004; 141: 352-359
15 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
16 Chen SC, Rex DK. Endoscopist can be more powerful than age and male gender in predicting adenoma detection at colonoscopy. Am J Gastroenterol 2007; 102: 856-861
17 Pohl H, Srivastava A, Bensen SP et al. Incomplete polyp resection during colonoscopy – results of the complete adenoma resection (CARE) study. Gastroenterology 2013; 144: 74-80.e1
18 Singh H, Nugent Z, Demers AA et al. The reduction in colorectal cancer mortality after colonoscopy varies by site of the cancer. Gastroenterology 2010; 139: 1128-1137
19 Baxter NN, Goldwasser MA, Paszat LF et al. Association of colonoscopy and death from colorectal cancer. Ann Intern Med 2009; 150: 1-8
20 Brenner H, Hoffmeister M, Arndt V et al. Protection from right- and left-sided colorectal neoplasms after colonoscopy: population-based study. J Natl Cancer Inst 2010; 102: 89-95
21 Baxter NN, Warren JL, Barrett MJ et al. Association between colonoscopy and colorectal cancer mortality in a US cohort according to site of cancer and colonoscopist specialty. J Clin Oncol 2012; 30: 2664-2669
22 Lakoff J, Paszat LF, Saskin R et al. Risk of developing proximal versus distal colorectal cancer after a negative colonoscopy: a population-based study. Clin Gastroenterol Hepatol 2008; 6: 1117-1121
23 Singh H, Nugent Z, Demers AA et al. Rate and predictors of early/missed colorectal cancers after colonoscopy in Manitoba: a population-based study. Am J Gastroenterol 2010; 105: 2588-2596
24 Brenner H, Chang-Claude J, Seiler CM et al. Does a negative screening colonoscopy ever need to be repeated?. Gut 2006; 55: 1145-1150
25 Brenner H, Chang-Claude J, Seiler CM et al. Protection from colorectal cancer after colonoscopy: a population-based, case-control study. Ann Intern Med 2011; 154: 22-30
26 Valori RM, Morris JE, Thomas JD et al. Tu1485 Rates of post colonoscopy colorectal cancer (PCCRC) are significantly affected by methodology, but are nevertheless declining in the English NHS [abstract]. Gastrointest Endosc 2014; 79: AB451
27 Yalamarthi S, Witherspoon P, McCole D et al. Missed diagnoses in patients with upper gastrointestinal cancers. Endoscopy 2004; 36: 874-879
28 Raftopoulos SC, Segarajasingam DS, Burke V et al. A cohort study of missed and new cancers after esophagogastroduodenoscopy. Am J Gastroenterol 2010; 105: 1292-1297
29 Cohen J, Safdi MA, Deal SE et al. Quality indicators for esophagogastroduodenoscopy. Am J Gastroenterol 2006; 101: 886-891
30 Faigel DO, Pike IM, Baron TH et al. Quality indicators for gastrointestinal endoscopic procedures: an introduction. Am J Gastroenterol 2006; 101: 866-872
31 Park WG, Cohen J. Quality measurement and improvement in upper endoscopy. Techniques Gastrointest Endosc 2012; 14: 13-20
32 Gavin DR, Valori RM, Anderson JT et al. The national colonoscopy audit: a nationwide assessment of the quality and safety of colonoscopy in the UK. Gut 2013; 62: 242-249
33 Enochsson L, Swahn F, Arnelo U et al. Nationwide, population-based data from 11,074 ERCP procedures from the Swedish Registry for Gallstone Surgery and ERCP. Gastrointest Endosc 2010; 72: 1175-1184, 1184.e1 – e3
34 Baron TH, Petersen BT, Mergener K et al. Quality indicators for endoscopic retrograde cholangiopancreatography. Am J Gastroenterol 2006; 101: 892-897
35 Cotton PB, Garrow DA, Gallagher J et al. Risk factors for complications after ERCP: a multivariate analysis of 11,497 procedures over 12 years. Gastrointest Endosc 2009; 70: 80-88
36 Consortium. TANS. Appraisal of guidelines for research and evaluation II. AGREE II Instrument. 2009: 1-56
37 Jaeschke R, Guyatt GH, Dellinger P et al. Use of GRADE grid to reach decisions on clinical practice guidelines when consensus is elusive. BMJ 2008; 337: a744
38 Murphy MK, Black NA, Lamping DL et al. Consensus development methods, and their use in clinical guideline development. Health Technol Assess 1998; 2: i-iv, 1 – 88
39 Greenhalgh T. How to read a paper. Getting your bearings (deciding what the paper is about). BMJ 1997; 315: 243-246
40 O’Connor D, Green S, Higgins JP. Defining the review question and developing criteria for including studies. In: Higgins JPT, Green S, editors. Cochrane handbook for systematic reviews of interventions. Oxford, UK: Wiley-Blackwell; 2008
41 Richardson WS, Wilson MC, Nishikawa J et al. The well-built clinical question: a key to evidence-based decisions. ACP J Club 1995; 123: A12-A13
42 Shea BJ, Grimshaw JM, Wells GA et al. Development of AMSTAR: a measurement tool to assess the methodological quality of systematic reviews. BMC Med Res Methodol 2007; 7: 10
43 Higgins JP, Altman DG, Gotzsche PC et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ 2011; 343: d5928
44 Wells GA, Shea B, O’Connell DJ et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Available at: http://www.ohri.ca/programs/clinical_epidemiology/oxford.htm Accessed: 2015
45 Whiting PF, Rutjes AW, Westwood ME et al. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med 2011; 155: 529-536
46 Effective Practice and Organisation of Care (EPOC). Suggested risk of bias criteria for EPOC reviews. EPOC. Resources for review authors. Oslo.: Norwegian Knowledge Centre for the Health Services; Available at: http://epoc.cochrane.org/epoc-specific-resources-review-authors Accessed: 2015
47 Guyatt GH, Oxman AD, Vist GE et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 2008; 336: 924-926
48 Guyatt GH, Oxman AD, Kunz R et al. What is “quality of evidence” and why is it important to clinicians?. BMJ 2008; 336: 995-998
49 GRADE Working Group. http://www.gradeworkinggroup.org/ Accessed 2015
50 ISFU system; National Quality Measures Clearinghouse (NQMC). http://www.qualitymeasures.ahrq.gov
51 ISFU criteria; National Quality Measures Clearinghouse (NQMC). http://www.qualitymeasures.ahrq.gov
52 Gavin DR, Valori RM, Anderson JT et al. The national colonoscopy audit: a nationwide assessment of the quality and safety of colonoscopy in the UK. Gut 2013; 62: 242-249
53 Birkmeyer JD, Stukel TA, Siewers AE et al. Surgeon volume and operative mortality in the United States. N Engl J Med 2003; 349: 2117-2127