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Review
Quality indicators in endoscopic retrograde cholangiopancreatography: a brief review of established guidelines
Zubin Dev Sharma, Rajesh Puri
Clin Endosc 2023;56(3):290-297.   Published online April 11, 2023
DOI: https://doi.org/10.5946/ce.2022.210
AbstractAbstract PDFPubReaderePub
Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive endoscopic technique that has many diagnostic and therapeutic implications. It is a procedure with small but significant life-threatening complications. To ensure the best possible care, minimize complications, and improve the quality of health care, a constant review of the performance of the operator using ideal benchmark standards is needed. Hence, quality indicators are necessary. The American and European Societies of Gastrointestinal Endoscopy have provided guidelines on quality measures for ERCP, which describe the skills to be developed and training to be implemented in performing quality ERCP. These guidelines have divided the indicators into pre-procedure, intraprocedural, and post-procedure measures. The focus of this article was to review the quality indicators of ERCP.

Citations

Citations to this article as recorded by  
  • Advancements in Research on Challenges in Selective Biliary Cannulation during Endoscopic Retrograde Cholangiopancreatography (ERCP)
    天雨 张
    Journal of Clinical Personalized Medicine.2024; 03(01): 100.     CrossRef
  • Development of an Automated Endoscopic Retrograde Cholangiopancreatography Quality Report Card Using an Integrated Analytics Suite
    Anmol Singh, Eric Swei, Celestina Tolosa, Matthew Alverson, Todd A. Brenner, Avleen Kaur, Aida Metri, Mohammed Rifat Shaik, Nikhil Bush, Branislav Bujnak, Alexandra T. Strauss, Mouen Khashab, Eun Ji Shin, Vikesh K. Singh, Venkata S. Akshintala
    Techniques and Innovations in Gastrointestinal Endoscopy.2024;[Epub]     CrossRef
  • Validity of a virtual reality endoscopic retrograde cholangiopancreatography simulator: can it distinguish experts from novices?
    Konstantinos Georgiou, Nikola Boyanov, Pantelis Antonakis, Dimitrios Thanasas, Gabriel Sandblom, Lars Enochsson
    Frontiers in Surgery.2023;[Epub]     CrossRef
  • 2,240 View
  • 181 Download
  • 1 Web of Science
  • 3 Crossref
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Original Article
Exploring quality indicators for the detection of Helicobacter pylori-naïve gastric cancer: a cross-sectional nationwide survey
Fumiaki Ishibashi, Toshiaki Hirasawa, Hiroya Ueyama, Yohei Minato, Sho Suzuki
Clin Endosc 2023;56(4):460-469.   Published online April 4, 2023
DOI: https://doi.org/10.5946/ce.2022.167
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: Diagnosis of Helicobacter pylori-naïve gastric cancer (HPNGC) is becoming increasingly important. This study aimed to explore the quality indicators for HPNGC detection.
Methods
We conducted a cross-sectional, nationwide, web-based survey of gastrointestinal endoscopists in Japan. In addition to questions about the number of HPNGC cases detected in a year and basic information, the questionnaire also consisted of 28 questions: (1) 18 about HPNGC awareness, (2) six about diagnostic proactiveness, and (3) four about interest in HPNGC.
Results
Valid responses were obtained from 712 endoscopists. The Japan Gastroenterological Endoscopy Society-certified endoscopists had a significantly higher HPNGC detection rate than the nonspecialists (0.42% vs. 0.32%, respectively; p=0.008). The results of the multiple regression analysis showed that Japan Gastroenterological Endoscopy Society certification and high awareness and interest scores were independent predictors of the HPNGC detection rate (p=0.012, p<0.001, p=0.024, respectively). Principal component analysis showed that the endoscopists who attended conferences for collecting information on HPNGC had a higher level of awareness.
Conclusions
To improve the detection of HPNGC, it is necessary to increase the awareness of the disease. It is hoped that relevant societies will play an important role in endoscopists’ education.

Citations

Citations to this article as recorded by  
  • Prevalence of Gastric Epithelial Tumors in Helicobacter pylori-uninfected Individuals Undergoing a Medical Checkup
    Eiko Okimoto, Kyoichi Adachi, Yuri Ebisutani, Norihisa Ishimura, Shunji Ishihara
    Internal Medicine.2024;[Epub]     CrossRef
  • Improving the quality of the esophagogastroduodenoscopy in Helicobacter pylori-naïve gastric cancer
    Jae Myung Park
    Clinical Endoscopy.2023; 56(4): 453.     CrossRef
  • 2,616 View
  • 130 Download
  • 1 Web of Science
  • 2 Crossref
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Reviews
Quality indicators in esophagogastroduodenoscopy
Sang Yoon Kim, Jae Myung Park
Clin Endosc 2022;55(3):319-331.   Published online May 16, 2022
DOI: https://doi.org/10.5946/ce.2022.094
AbstractAbstract PDFPubReaderePub
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.

Citations

Citations to this article as recorded by  
  • Current status of quality control in screening esophagogastroduodenoscopy and the emerging role of artificial intelligence
    Lihui Zhang, Liwen Yao, Zihua Lu, Honggang Yu
    Digestive Endoscopy.2024; 36(1): 5.     CrossRef
  • Relationship between observation time and detection rate of focal lesions in Esophagogastroduodenoscopy: a single-center, retrospective study
    Li Dong, Xiaodan Zhang, Yuting Xuan, Peiling Xiong, Yumei Ning, Bing Zhang, Fan Wang, Qiu Zhao, Jun Fang
    BMC Gastroenterology.2024;[Epub]     CrossRef
  • The Effect of Esophagogastroduodenoscopy on Intraocular Pressure
    Maddalena De Bernardo, Antonella Santonicola, Marco Gioia, Livio Vitiello, Ferdinando Cione, Sergio Pagliarulo, Paola Iovino, Nicola Rosa
    Journal of Clinical Medicine.2024; 13(5): 1224.     CrossRef
  • The Diagnostic Performance of Linked Color Imaging Compared to White Light Imaging in Endoscopic Diagnosis of Helicobacter pylori Infection: A Systematic Review and Meta-Analysis
    Jae Gon Lee, In Kyung Yoo, Abdullah Ozgur Yeniova, Sang Pyo Lee
    Gut and Liver.2024; 18(3): 444.     CrossRef
  • Endoscopic Imaging for the Diagnosis of Neoplastic and Pre-Neoplastic Conditions of the Stomach
    Bruno Costa Martins, Renata Nobre Moura, Angelo So Taa Kum, Carolina Ogawa Matsubayashi, Sergio Barbosa Marques, Adriana Vaz Safatle-Ribeiro
    Cancers.2023; 15(9): 2445.     CrossRef
  • The effect of short-term training about depth predicting score on the diagnostic ability of invasion depth for differentiated early gastric Cancer among non-expert endoscopists
    Hui Li, Hui Hu, Ping Geng, Panhui Guo, Yuanrong Zhu, Lulu Zeng, Jun Liu, Xiangpeng Hu
    BMC Medical Education.2023;[Epub]     CrossRef
  • Variation in the rate of detection of minute and small early gastric cancers at diagnostic endoscopy may reflect the performance of individual endoscopists
    Daisuke Murakami, Masayuki Yamato, Yuji Amano, Takayoshi Nishino, Makoto Arai
    BMJ Open Gastroenterology.2023; 10(1): e001143.     CrossRef
  • Improving the quality of the esophagogastroduodenoscopy in Helicobacter pylori-naïve gastric cancer
    Jae Myung Park
    Clinical Endoscopy.2023; 56(4): 453.     CrossRef
  • Simethicone and N-acetyl cysteine in improving mucosal visibility: Towards a “clearer view” during endoscopy
    Akash Roy, Mahesh K. Goenka
    Indian Journal of Gastroenterology.2023;[Epub]     CrossRef
  • Enhancing the Quality of Upper Gastrointestinal Endoscopy: Current Indicators and Future Trends
    Caesar Ferrari, Micheal Tadros
    Gastroenterology Insights.2023; 15(1): 1.     CrossRef
  • Antispasmodic Agent Administration Improves Gastric Neoplasm Detection Rates during Esophagogastroduodenoscopy
    Sang Yoon Kim, Jae Myung Park
    The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2022; 22(3): 246.     CrossRef
  • Clinical features of gastric adenoma detected within 3 years after negative screening endoscopy in Korea
    Hyun Young Kim
    Gastroenterology Report.2022;[Epub]     CrossRef
  • 8,441 View
  • 509 Download
  • 12 Web of Science
  • 12 Crossref
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Quality indicators in colonoscopy: the chasm between ideal and reality
Su Bee Park, Jae Myung Cha
Clin Endosc 2022;55(3):332-338.   Published online April 4, 2022
DOI: https://doi.org/10.5946/ce.2022.037
AbstractAbstract PDFPubReaderePub
Continuous measurement of quality indicators (QIs) should be a routine part of colonoscopy, as a wide variation still exists in the performance and quality levels of colonoscopy in Korea. Among the many QIs of colonoscopy, the adenoma detection rate, average withdrawal time, bowel preparation adequacy, and cecal intubation rate should be monitored in daily clinical practice to improve the quality of the procedure. The adenoma detection rate is the best indicator of the quality of colonoscopy; however, it has many limitations for universal use in daily practice. With the development of natural language processing, the adenoma detection rate is expected to become more effective and useful. It is important that colonoscopists do not strictly and mechanically maintain an average withdrawal time of 6 minutes but instead perform careful colonoscopy to maximally expose the colonic mucosa with a withdrawal time of at least 6 minutes. To achieve adequate bowel preparation, documentation of bowel preparation with the Boston Bowel Preparation Scale (BBPS) should be a routine part of colonoscopy. When colonoscopists routinely followed the bowel preparation protocols, ≥85% of outpatient screening colonoscopies had a BBPS score of ≥6. In addition, the cecal intubation rate should be ≥95% of all screening colonoscopies. The first step in improving colonoscopy quality in Korea is to apply these key performance measurements in clinical practice.

Citations

Citations to this article as recorded by  
  • What are the priority quality indicators for colonoscopy in real‐world clinical practice?
    Kasenee Tiankanon, Satimai Aniwan
    Digestive Endoscopy.2024; 36(1): 30.     CrossRef
  • A Systematic Review of Exercise Therapy for Bowel Preparation
    Yuan-Yuan Zhang, Ramoo Vimala, Ping Lei Chui, Ida Normiha Hilmi
    Gastroenterology Nursing.2023; 46(5): 393.     CrossRef
  • Detecting colorectal lesions with image-enhanced endoscopy: an updated review from clinical trials
    Mizuki Nagai, Sho Suzuki, Yohei Minato, Fumiaki Ishibashi, Kentaro Mochida, Ken Ohata, Tetsuo Morishita
    Clinical Endoscopy.2023; 56(5): 553.     CrossRef
  • AI-powered medical devices for practical clinicians including the diagnosis of colorectal polyps
    Donghwan Kim, Eunsun Kim
    Journal of the Korean Medical Association.2023; 66(11): 658.     CrossRef
  • 3,125 View
  • 219 Download
  • 5 Web of Science
  • 4 Crossref
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Original Articles
Impact of the COVID-19 Outbreak on Anesthesiologist Assistance for Endoscopic Procedures
Calcedonio Calcara, Camilla Ciscato, Arnaldo Amato, Emanuele Sinagra, Costanza Alvisi, Sandro Ardizzone, Andrea Anderloni, Pietro Gambitta, on behalf of the FISMAD Lombardy COVID-19 Impact on Anesthesiologist-Assisted Endoscopy Study Group
Clin Endosc 2022;55(1):49-57.   Published online January 27, 2022
DOI: https://doi.org/10.5946/ce.2021.191
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: The coronavirus disease 2019 (COVID-19) outbreak has modified the activities of endoscopy units worldwide. Herein, we investigated the impact of the COVID-19 outbreak on anesthesiologist assistance for endoscopic procedures in Lombardy, Italy.
Methods
A questionnaire concerning anesthesiologist assistance provided from October 26 to December 6, 2020, in comparison with the same period in 2019, was sent to endoscopic units in Lombardy.
Results
Approximately 54% (34/63) of the units responded. A reduction in the number of all endoscopies (-33.5%; 18792 in 2020 vs. 28264 in 2019) and anesthesiologist-assisted endoscopies (-15.3%; 2652 in 2020 vs. 3132 in 2019) was reported. A greater reduction in anesthesiologist assistance was observed in government community units (-29.5%) than in academic (-14%) and private community units (-4.6%). Among all units, 85% reported a reduction in anesthesiologist assistance; 65% observed a delay/cancellation of procedures; 59%, a restricted patient selection; 17%, the need to transfer some patients to other hospitals; and 32%, a related worsening of procedure quality.
Conclusion
The COVID-19 pandemic compromised the anesthesiologist assistance for endoscopic procedures in Lombardy, which worsened the procedure quality mainly in government community units. The COVID-19 “stress test” suggests a more balanced allocation of anesthesiologic resources in the future.

Citations

Citations to this article as recorded by  
  • COVID-19 and the Pancreas: A Narrative Review
    Emanuele Sinagra, Endrit Shahini, Federica Crispino, Ina Macaione, Valentina Guarnotta, Marta Marasà, Sergio Testai, Socrate Pallio, Domenico Albano, Antonio Facciorusso, Marcello Maida
    Life.2022; 12(9): 1292.     CrossRef
  • 3,716 View
  • 141 Download
  • 1 Web of Science
  • 1 Crossref
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Effectiveness of Solution with 5% Detergent for Cleaning Transnasal Esophagogastroduodenoscopy Lens
Yoshinori Komazawa, Mika Yuki, Nobuhiko Fukuba, Yoshiya Kobayashi, Hitomi Ishitobi, Sayaka Nakashima, Makoto Nagaoka, Yoshiko Takahashi, Toshihiro Shizuku
Clin Endosc 2021;54(2):236-241.   Published online January 19, 2021
DOI: https://doi.org/10.5946/ce.2020.062
AbstractAbstract PDFPubReaderePub
Background
/Aims: Unsedated transnasal esophagogastroduodenoscopy (EGD) is affected by a poor scope lens-cleaning function. We have previously reported good, albeit limited, effects of an oolong tea washing solution; here, we evaluated the effectiveness of a 5% lens cleaning solution for cleaning an EGD lens.
Methods
Five percent lens cleaning solution (C), 5% dimethicone solution (D), and distilled water (W) were prepared. Study I: Lenses were soiled with pork grease, washed with each washing solution, and their image quality was judged. Study II: Patients (n=996) scheduled for transnasal EGD were randomly assigned to the C- or W-group. Lens cleanliness level, washing solution volume used, and endoscopist stress due to lens contamination were determined.
Results
Study I: The image quality of the lenses washed with (C) was significantly superior. (D) was clinically unsuitable because of spray nozzle clogging. Study II: Lens cleaning in the C-group was significantly superior (p<0.0001) and the solution volume required was significantly reduced (p<0.0001), while endoscopist stress was also lower (p<0.0001).
Conclusions
For transnasal small-caliber EGD, the present 5% lens cleaning solution provided good visibility. It features a high detergency level and is simple to formulate for therapeutic endoscopy applications, such as endoscopic submucosal dissection.
  • 3,548 View
  • 117 Download
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Quality Indicators for the Detection of Helicobacter pylori-Negative Early Gastric Cancer: A Retrospective Observational Study
Fumiaki Ishibashi, Konomi Kobayashi, Keita Fukushima, Ryu Tanaka, Tomohiro Kawakami, Junko Kato, Kazuaki Sugihara
Clin Endosc 2020;53(6):698-704.   Published online March 13, 2020
DOI: https://doi.org/10.5946/ce.2019.203
AbstractAbstract PDFPubReaderePub
Background
/Aims: While Helicobacter pylori (HP)-negative gastric cancer is frequently reported, little is known about the predictors for detecting HP-negative early gastric cancer (EGC). We aimed to evaluate the predictors for the detection of HP-negative EGC.
Methods
We retrospectively reviewed 13,477 consecutive asymptomatic cases where upper endoscopy was performed by nine physicians from April 2017 to March 2019 and analyzed the detection rate of high-risk lesions (HRLs), including EGC, tubular adenoma, and lymphoma, according to the status of HP infection. The observation time was corrected for multiple regression analyses.
Results
For all physicians, the average observation time for screening HP-eradicated and -naïve patients was shorter than that for screening HP-positive patients (p<0.05). Multiple regression analyses revealed that the observation time in the three groups was an independent predictor for detecting HRLs in HP-eradicated patients (p=0.03106, 0.01263, and 0.02485, respectively), while experience of endoscopy was an independent predictor for detecting HRLs in HP-naïve patients (p=0.02638).
Conclusions
While observation time during screening endoscopy was a quality indicator for detecting HRLs in HP-eradicated patients, experience of endoscopy was a quality indicator for detecting HRLs in HP-naïve patients.

Citations

Citations to this article as recorded by  
  • Exploring quality indicators for the detection of Helicobacter pylori-naïve gastric cancer: a cross-sectional nationwide survey
    Fumiaki Ishibashi, Toshiaki Hirasawa, Hiroya Ueyama, Yohei Minato, Sho Suzuki
    Clinical Endoscopy.2023; 56(4): 460.     CrossRef
  • A Close Follow-Up Strategy in the Short Period of Time after Helicobacter pylori Eradication Contributes to Earlier Detection of Gastric Cancer
    Fumiaki Ishibashi, Sho Suzuki, Mizuki Nagai, Kentaro Mochida, Konomi Kobayashi, Tetsuo Morishita
    Digestion.2023; 104(3): 165.     CrossRef
  • Endoscopic diagnosis of early gastric cancer
    Dong Chan Joo, Gwang Ha Kim
    Journal of the Korean Medical Association.2022; 65(5): 267.     CrossRef
  • Risk factors for early gastric cancer: focus on Helicobacter pylori gastritis
    Hee Seok Moon
    Journal of the Korean Medical Association.2022; 65(5): 259.     CrossRef
  • Tailored eradication strategy vs concomitant therapy for Helicobacter pylori eradication treatment in Korean patients
    Youn I Choi, Jun-Won Chung, Kyoung Oh Kim, Kwang An Kwon, Yoon Jae Kim, Jung Ho Kim, Ja Young Seo, Dong Kyun Park
    World Journal of Gastroenterology.2021; 27(31): 5247.     CrossRef
  • Quality management system for screening esophagogastroduodenoscopy improves detection of Helicobacter pylori-negative interval gastric cancer
    Fumiaki Ishibashi, Konomi Kobayashi, Tomohiro Kawakami, Ryu Tanaka, Kazuaki Sugihara, Satoshi Baba
    Endoscopy International Open.2021; 09(12): E1900.     CrossRef
  • Quality Indicator for Gastric Cancer Detection Based on Helicobacter pylori Status
    Jae Myung Park
    Clinical Endoscopy.2020; 53(6): 629.     CrossRef
  • 4,936 View
  • 180 Download
  • 7 Web of Science
  • 7 Crossref
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Special Review: Korean Society of Gastrointestinal Endoscopy “Accreditations of Qualified Endoscopy Unit” Guideline: Update 2019
Updates on the Disinfection and Infection Control Process of the Accredited Endoscopy Unit
Jeong Eun Shin, Yunho Jung, Jeong Hoon Lee, Byoung Kwan Son, Jae-Young Jang, Hyung-Keun Kim, Byung Ik Jang, The Quality Management Committee and the Disinfection Management Committee of Korean Society of Gastrointestinal Endoscopy
Clin Endosc 2019;52(5):443-450.   Published online September 30, 2019
DOI: https://doi.org/10.5946/ce.2019.173
AbstractAbstract PDFPubReaderePub
A thorough disinfection and infection control process associated with gastrointestinal endoscopy is highly important for the health and safety of the examinee and the medical staff involved in the procedure. Endoscopic reprocessing and disinfection are two of the most important steps in quality control of endoscopy. In 2019, the Korean Society of Gastrointestinal Endoscopy updated the Accreditation of Qualified Endoscopy Unit assessment items for these quality indicators. Assessment of disinfection and infection control comprises 28 mandatory items in the categories of disinfection education, pre-cleaning, cleaning, disinfection, rinsing, drying, reprocessing, storage, endoscopic accessories, water bottle and connectors, space/facilities, personal protective equipment, disinfection ledger, and regulations regarding infection control and disinfection.
The updated Accreditation of Qualified Endoscopy Unit assessment items are useful for improving the quality of endoscopy by ensuring thorough inspection of endoscopic disinfection and infection control.

Citations

Citations to this article as recorded by  
  • Analysis of sterilization efficiency and application cost of three low temperature sterilization methods
    Hui Chen, Jiawei Liu, Aiying Zeng, Nian Qin
    Review of Scientific Instruments.2024;[Epub]     CrossRef
  • Infection control in the bronchoscopy suite: effective reprocessing and disinfection of reusable bronchoscopes
    Mamta S. Chhabria, Fabien Maldonado, Atul C. Mehta
    Current Opinion in Pulmonary Medicine.2023; 29(1): 21.     CrossRef
  • Endoscopy in surgery
    María Rita Rodríguez-Luna, Silvana Perretta
    Frontiers in Gastroenterology.2023;[Epub]     CrossRef
  • Safety of Gastrointestinal Endoscopy in Korea: A Nationwide Survey and Population-Based Study
    Yunho Jung, Jung-Wook Kim, Jong Pil Im, Yu Kyung Cho, Tae Hee Lee, Jae-Young Jang
    Journal of Korean Medical Science.2022;[Epub]     CrossRef
  • A nationwide survey on the effectiveness of training on endoscope reprocessing within the national cancer screening program in Korea
    Hye Young Shin, Da Hun Jang, Jae Kwan Jun
    American Journal of Infection Control.2021; 49(8): 1031.     CrossRef
  • Effectiveness Between Daily and After-Each-Case Room Disinfection of the Endoscopy Unit
    Bo Jin, Yue Hu, Liang Huang, Xiaoyun Cheng, Jin Zhao, Xuejing Yang, Xiling Sun, Tieer Gan, Bin Lu
    Frontiers in Public Health.2021;[Epub]     CrossRef
  • Sans Standardization: Effective Endoscope Reprocessing
    Sameer K. Avasarala, Lawrence F. Muscarella, Atul C. Mehta
    Respiration.2021; 100(12): 1208.     CrossRef
  • Sharing Our Experience of Operating an Endoscopy Unit in the Midst of a COVID-19 Outbreak
    Jimin Han, Eun Young Kim
    Clinical Endoscopy.2020; 53(2): 243.     CrossRef
  • 4,581 View
  • 147 Download
  • 7 Web of Science
  • 8 Crossref
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Accredited Endoscopy Unit Program of Korea: Overview and Qualification
Jung-Wook Kim, Yu Kyung Cho, Jin-Oh Kim, Jae-Young Jang, the Quality Management Committee of Korean Society of Gastrointestinal Endoscopy
Clin Endosc 2019;52(5):426-430.   Published online September 30, 2019
DOI: https://doi.org/10.5946/ce.2019.166
AbstractAbstract PDFPubReaderePub
The Korean Society of Gastrointestinal Endoscopy introduced the Accredited Endoscopy Unit Program to enhance endoscopy unit quality through systematic quality management in 2012. It was gradually expanded from training hospitals to institutions with 100+ beds, and the criteria for certification were applied according to the actual conditions of each institution. On the basis of the continuous communication with the institutions and feedback, the Accredited Endoscopy Unit Program certification criteria were revised in 2019 and introduced as follows: (1) the qualification criteria for endoscopy doctors and nurses; (2) facilities and equipment; (3) endoscopic examination process; (4) performance; (5) disinfection and infection control; and (6) endoscopic sedation. The assessment items consist of essential and recommended items. All essential items must be met for accreditation to be awarded. The assessment criteria for each evaluation area were revised as follows: (1) upgrading assessment criteria; (2) qualification of endoscopists and reinforcement of quality control education; (3) detailed standards for safety, disinfection, endoscopic sedation, and management instructions; and (4) presentation of new performance measurement of endoscopy and colonoscopy.

Citations

Citations to this article as recorded by  
  • Safety of Gastrointestinal Endoscopy in Korea: A Nationwide Survey and Population-Based Study
    Yunho Jung, Jung-Wook Kim, Jong Pil Im, Yu Kyung Cho, Tae Hee Lee, Jae-Young Jang
    Journal of Korean Medical Science.2022;[Epub]     CrossRef
  • Total polyp number may be more important than size and histology of polyps for prediction of metachronous high-risk colorectal neoplasms
    Hyuk Yoon, Cheol Min Shin, Young Soo Park, Nayoung Kim, Dong Ho Lee
    BMC Gastroenterology.2022;[Epub]     CrossRef
  • Endoscopist-Driven Sedation Practices in South Korea: Re-evaluation Considering the Nationwide Survey in 2019
    Seon-Young Park, Jun Kyu Lee, Chang-Hwan Park, Byung-Wook Kim, Chang Kyun Lee, Hong Jun Park, Byung Ik Jang, Dong Uk Kim, Jin Myung Park, Jae Min Lee, Young Sin Cho, Hyung Ku Chon, Seung Young Seo, Woo Hyun Paik
    Gut and Liver.2022; 16(6): 899.     CrossRef
  • Accreditation of digestive endoscopy services: a method of quality assuring?
    Giancarlo Spinzi, Angelo Milano, Maurizio Capelli
    Expert Review of Gastroenterology & Hepatology.2021; 15(1): 1.     CrossRef
  • Important Quality Metrics and Standardization in Endoscopy
    Tossapol Kerdsirichairat, Eun Ji Shin
    Gastrointestinal Endoscopy Clinics of North America.2021; 31(4): 727.     CrossRef
  • A Nationwide Survey on the Facilities and Personnel for Endoscopic Sedation: Results from 50 Qualified Endoscopy Units of Teaching Hospitals Accredited by the Korean Society of Gastrointestinal Endoscopy (KSGE)
    Seon-Young Park, Jun Kyu Lee, Jung-Wook Kim, Tae Hee Lee, Chang-Hwan Park, Jae-Yong Jang, Byung-Wook Kim, Byung Ik Jang
    Clinical Endoscopy.2021; 54(6): 843.     CrossRef
  • Efficacy and Patient Tolerability Profiles of Probiotic Solution with Bisacodyl Versus Conventional Cleansing Solution for Bowel Preparation: A Prospective, Randomized, Controlled Trial
    Youn I Choi, Jong-Joon Lee, Jun-Won Chung, Kyoung Oh Kim, Yoon Jae Kim, Jung Ho Kim, Dong Kyun Park, Kwang An Kwon
    Journal of Clinical Medicine.2020; 9(10): 3286.     CrossRef
  • 3,990 View
  • 105 Download
  • 6 Web of Science
  • 7 Crossref
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Reviews
Quality Indicators in Barrett’s Esophagus: Time to Change the Status Quo
Samuel Han, Sachin Wani
Clin Endosc 2018;51(4):344-351.   Published online July 31, 2018
DOI: https://doi.org/10.5946/ce.2018.099
AbstractAbstract PDFPubReaderePub
The push for high quality care in all fields of medicine highlights the importance of establishing and adhering to quality indicators.In response, several gastrointestinal societies have established quality indicators specific to Barrett’s esophagus, which serve to createthresholds for performance while standardizing practice and guiding value-based care. Recent studies, however, have consistentlydemonstrated the lack of adherence to these quality indicators, particularly in surveillance (appropriate utilization of endoscopy andobtaining biopsies using the Seattle protocol) and endoscopic eradication therapy practices. These findings suggest that innovativeinterventions are needed to address these shortcomings in order to deliver high quality care to patients with Barrett’s esophagus.

Citations

Citations to this article as recorded by  
  • Measuring and improving quality in esophageal care and swallowing disorders
    Alexander T Reddy, Joshua P Lee, David A Leiman
    Diseases of the Esophagus.2024;[Epub]     CrossRef
  • Impact of Residing in Below Median Household Income Districts on Outcomes in Patients with Advanced Barrett’s Esophagus
    Suqing Li, Yusuke Fujiyoshi, Sechiv Jugnundan, Gary May, Norman Marcon, Jeffrey Mosko, Christopher Teshima
    Journal of the Canadian Association of Gastroenterology.2023; 6(4): 137.     CrossRef
  • Clinical variation in surveillance and management of Barrett’s esophagus: A cross-sectional study of gastroenterologists and gastrointestinal surgeons
    Jamielyn DC Cruz, David Paculdo, Divya Ganesan, Meredith Baker, Rebecca J Critchley-Thorne, Nicholas J Shaheen, Sachin Wani, John W Peabody
    Medicine.2022; 101(51): e32187.     CrossRef
  • Risk Factors for Self-Expandable Metal Stent Complications in the Treatment of Esophageal Cancer: A Scoping Review
    Connor K. Wilson, Sara R. Frankowski, Susan C. Steelman, Issam Makhoul
    SN Comprehensive Clinical Medicine.2020; 2(8): 1163.     CrossRef
  • 5,789 View
  • 102 Download
  • 3 Web of Science
  • 4 Crossref
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Revision of Quality Indicators for the Endoscopy Quality Improvement Program of the National Cancer Screening Program in Korea
Jun Ki Min, Jae Myung Cha, Yu Kyung Cho, Jie-Hyun Kim, Soon Man Yoon, Jong Pil Im, Yunho Jung, Jeong Seop Moon, Jin-Oh Kim, Yoon Tae Jeen
Clin Endosc 2018;51(3):239-252.   Published online May 31, 2018
DOI: https://doi.org/10.5946/ce.2018.075
AbstractAbstract PDFPubReaderePub
Gastroscopy and colonoscopy are widely used for the early diagnosis of stomach and colorectal cancer. The present revision integrates recent data regarding previous quality indicators and novel indicators suggested for gastroscopy and colonoscopy procedures for the National Cancer Screening Program in Korea. The new indicators, developed by the Quality Improvement Committee of the Korean Society for Gastrointestinal Endoscopy, vary in the level of supporting evidence, and most are based solely on expert opinion. Updated indicators validated by clinical research were prioritized, but were chosen by expert consensus when such studies were absent. The resultant quality indicators were graded according to the levels of consensus and recommendations. The updated indicators will provide a relevant guideline for high-quality endoscopy. The future direction of quality indicator development should include relevant outcome measures and an evidence-based approach to support proposed performance targets.

Citations

Citations to this article as recorded by  
  • Current status of quality control in screening esophagogastroduodenoscopy and the emerging role of artificial intelligence
    Lihui Zhang, Liwen Yao, Zihua Lu, Honggang Yu
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Quality is the Key for Emerging Issues of Population-Based Colonoscopy Screening
Jin Young Yoon, Jae Myung Cha, Yoon Tae Jeen, on behalf of Medical Policy Committee of Korean Association for the Study of Intestinal Diseases (KASID), Quality Improvement Committee of Korean Society of Gastrointestinal Endoscopy (KSGE)
Clin Endosc 2018;51(1):50-55.   Published online January 31, 2018
DOI: https://doi.org/10.5946/ce.2018.010
AbstractAbstract PDFPubReaderePub
Colonoscopy is currently regarded as the gold standard and preferred method of screening for colorectal cancer (CRC). However, the benefit of colonoscopy screening may be blunted by low participation rates in population-based screening programs. Harmful effects of population-based colonoscopy screening may include complications induced by colonoscopy itself and by sedation, psychosocial distress, potential over-diagnosis, and socioeconomic burden. In addition, harmful effects of colonoscopy may increase with age and comorbidities. As the risk of adverse events in population-based colonoscopy screening may offset the benefit, the adverse events should be managed and monitored. To adopt population-based colonoscopy screening, consensus on the risks and benefits should be developed, focusing on potential harm, patient preference, socioeconomic considerations, and quality improvement of colonoscopy, as well as efficacy for CRC prevention. As suboptimal colonoscopy quality is a major pitfall of population-based screening, adequate training and regulation of screening colonoscopists should be the first step in minimizing variations in quality. Gastroenterologists should promote quality improvement, auditing, and training for colonoscopy in a population-based screening program.

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Quality Indicators for Small Bowel Capsule Endoscopy
Ki-Nam Shim, Seong Ran Jeon, Hyun Joo Jang, Jinsu Kim, Yun Jeong Lim, Kyeong Ok Kim, Hyun Joo Song, Hyun Seok Lee, Jae Jun Park, Ji Hyun Kim, Jaeyoung Chun, Soo Jung Park, Dong-Hoon Yang, Yang Won Min, Bora Keum, Bo-In Lee, Korean Gut Image Study Group
Clin Endosc 2017;50(2):148-160.   Published online March 30, 2017
DOI: https://doi.org/10.5946/ce.2017.030
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Capsule endoscopy (CE) enables evaluation of the entire mucosal surface of the small bowel (SB), which is one of the most important steps for evaluating obscure gastrointestinal bleeding. Although the diagnostic yield of SB CE depends on many clinical factors, there are no reports on quality indicators. Thus, the Korean Gut Image Study Group (KGISG) publishes an article titled, “Quality Indicators for Small Bowel Capsule Endoscopy” under approval from the Korean Society of Gastrointestinal Endoscopy (KSGE). Herein, we initially identified process quality indicators, while the structural and outcome indicators are reserved until sufficient clinical data are accumulated. We believe that outcomes of SB CE can be improved by trying to meet our proposed quality indicators.

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Original Article
Characteristics of Missed Simultaneous Gastric Lesions Based on Double-Check Analysis of the Endoscopic Image
Eun Jeong Gong, Jeong Hoon Lee, Kyoungwon Jung, Charles J. Cho, Hee Kyong Na, Ji Yong Ahn, Kee Wook Jung, Do Hoon Kim, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung, Jin-Ho Kim
Clin Endosc 2017;50(3):261-269.   Published online August 22, 2016
DOI: https://doi.org/10.5946/ce.2016.056
AbstractAbstract PDFPubReaderePub
Background
/Aims: The detection of multifocal lesions is important for the successful management of gastric neoplasms. We investigated the characteristics of missed simultaneous lesions and the reason for the missed diagnoses.
Methods
A total of 140 patients who underwent repeat endoscopy before endoscopic resection between June 2013 and June 2014 were retrospectively reviewed. We classified simultaneous lesions into three groups based on a review of earlier images: group 1, no images of the location of simultaneous lesions were taken; group 2, no corresponding lesion was evident in the previous images; and group 3, simultaneous lesions were visible in the earlier images but a biopsy was not performed.
Results
Simultaneous lesions were found in 12 patients (8.6%) with 13 lesions, comprising 10 dysplasia (76.9%) and three adenocarcinoma (23.1%). Regarding the reasons for missed diagnoses, seven lesions (53.8%) were classified as group 3, five (38.5%) as group 1, and the remaining lesion (7.7%) as group 2. There were no significant differences in the characteristics of the patients with and without simultaneous lesions.
Conclusions
Lesions disregarded or unnoticed during endoscopic examination were the main reason for missed diagnosis of simultaneous lesions. Endoscopists should consider the possibility of simultaneous lesions and attempt to meticulously evaluate the entire gastric mucosa.

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Review
How to Improve the Quality of Screening Endoscopy in Korea: National Endoscopy Quality Improvement Program
Yu Kyung Cho
Clin Endosc 2016;49(4):312-317.   Published online July 29, 2016
DOI: https://doi.org/10.5946/ce.2016.084
AbstractAbstract PDFPubReaderePub
In Korea, gastric cancer screening, either esophagogastroduodenoscopy or upper gastrointestinal series (UGIS), is performed biennially for adults aged 40 years or older. Screening endoscopy has been shown to be associated with localized cancer detection and better than UGIS. However, the diagnostic sensitivity of detecting cancer is not satisfactory. The National Endoscopy Quality Improvement (QI) program was initiated in 2009 to enhance the quality of medical institutions and improve the effectiveness of the National Cancer Screening Program (NCSP). The Korean Society of Gastrointestinal Endoscopy developed quality standards through a broad systematic review of other endoscopic quality guidelines and discussions with experts. The standards comprise five domains: qualifications of endoscopists, endoscopic unit facilities and equipment, endoscopic procedure, endoscopy outcomes, and endoscopic reprocessing. After 5 years of the QI program, feedback surveys showed that the perception of QI and endoscopic practice improved substantially in all domains of quality, but the quality standards need to be revised. How to avoid missing cancer in endoscopic procedures in daily practice was reviewed, which can be applied to the mass screening endoscopy. To improve the quality and effectiveness of NCSP, key performance indicators, acceptable quality standards, regular audit, and appropriate reimbursement are necessary.

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Original Article
Feedback Survey of the Effect, Burden, and Cost of the National Endoscopic Quality Assessment Program during the Past 5 Years in Korea
Yu Kyung Cho, Jeong Seop Moon, Dong Su Han, Yong Chan Lee, Yeol Kim, Bo Young Park, Il-Kwun Chung, Jin-Oh Kim, Jong Pil Im, Jae Myung Cha, Hyun Gun Kim, Sang Kil Lee, Hang Lak Lee, Jae Young Jang, Eun Sun Kim, Yunho Jung, Chang Mo Moon, Ethics and Quality Control Committee of Korean Society of Gastrointestinal Endoscopy
Clin Endosc 2016;49(6):542-547.   Published online March 2, 2016
DOI: https://doi.org/10.5946/ce.2015.113
AbstractAbstract PDFPubReaderePub
Background
/Aims: In Korea, the nationwide gastric cancer screening program recommends biennial screening for individuals aged 40 years or older by way of either an upper gastrointestinal series or endoscopy. The national endoscopic quality assessment (QA) program began recommending endoscopy in medical institutions in 2009. We aimed to assess the effect, burden, and cost of the QA program from the viewpoint of medical institutions.
Methods
We surveyed the staff of institutional endoscopic units via e-mail.
Results
Staff members from 67 institutions replied. Most doctors were endoscopic specialists. They responded as to whether the QA program raised awareness for endoscopic quality (93%) or improved endoscopic practice (40%). The percentages of responders who reported improvements in the diagnosis of gastric cancer, the qualifications of endoscopists, the quality of facilities and equipment, endoscopic procedure, and endoscopic reprocessing were 69%, 60%, 66%, 82%, and 75%, respectively. Regarding reprocessing, many staff members reported that they had bought new automated endoscopic preprocessors (3%), used more disinfectants (34%), washed endoscopes longer (28%), reduced the number of endoscopies performed to adhere to reprocessing guidelines (9%), and created their own quality education programs (59%). Many responders said they felt that QA was associated with some degree of burden (48%), especially financial burden caused by purchasing new equipment. Reasonable quality standards (45%) and incentives (38%) were considered important to the success of the QA program.
Conclusions
Endoscopic quality has improved after 5 years of the mandatory endoscopic QA program.

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Review
Image Quality Analysis of Various Gastrointestinal Endoscopes: Why Image Quality Is a Prerequisite for Proper Diagnostic and Therapeutic Endoscopy
Weon Jin Ko, Pyeong An, Kwang Hyun Ko, Ki Baik Hahm, Sung Pyo Hong, Joo Young Cho
Clin Endosc 2015;48(5):374-379.   Published online September 30, 2015
DOI: https://doi.org/10.5946/ce.2015.48.5.374
AbstractAbstract PDFPubReaderePub

Arising from human curiosity in terms of the desire to look within the human body, endoscopy has undergone significant advances in modern medicine. Direct visualization of the gastrointestinal (GI) tract by traditional endoscopy was first introduced over 50 years ago, after which fairly rapid advancement from rigid esophagogastric scopes to flexible scopes and high definition videoscopes has occurred. In an effort towards early detection of precancerous lesions in the GI tract, several high-technology imaging scopes have been developed, including narrow band imaging, autofocus imaging, magnified endoscopy, and confocal microendoscopy. However, these modern developments have resulted in fundamental imaging technology being skewed towards red-green-blue and this technology has obscured the advantages of other endoscope techniques. In this review article, we have described the importance of image quality analysis using a survey to consider the diversity of endoscope system selection in order to better achieve diagnostic and therapeutic goals. The ultimate aims can be achieved through the adoption of modern endoscopy systems that obtain high image quality.

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    Weon Jin Ko
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Focused Review Series: Globalization and Universalization of ESD
Principles of Quality Controlled Endoscopic Submucosal Dissection with Appropriate Dissection Level and High Quality Resected Specimen
Takashi Toyonaga, Eisei Nishino, Mariko Man-i, James E. East, Takeshi Azuma
Clin Endosc 2012;45(4):362-374.   Published online November 30, 2012
DOI: https://doi.org/10.5946/ce.2012.45.4.362
AbstractAbstract PDFPubReaderePub

Endoscopic submucosal dissection (ESD) has enabled en bloc resection of early stage gastrointestinal tumors with negligible risk of lymph node metastasis, regardless of tumor size, location, and shape. However, ESD is a relatively difficult technique compared with conventional endoscopic mucosal resection, requiring a longer procedure time and potentially causing more complications. For safe and reproducible procedure of ESD, the appropriate dissection of the ramified vascular network in the level of middle submucosal layer is required to reach the avascular stratum just above the muscle layer. The horizontal approach to maintain the appropriate depth for dissection beneath the vascular network enables treatment of difficult cases with large vessels and severe fibrosis. The most important aspect of ESD is the precise evaluation of curability. This approach can also secure the quality of the resected specimen with enough depth of the submucosal layer.

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Original Article
Usefulness of Real-time Measurement of Colonoscopy Withdrawal Time during Fellow Training
Chung Hyun Tae, M.D., Sung-Ae Jung, M.D., Seung-Jung Jun, M.D., Sun-Hee Roh, M.D., Ju Young Choi, M.D., Min Jung Kang, M.D., Ji Min Jung, M.D., Seong-Eun Kim, M.D., Ki-Nam Shim, M.D., Hey-Kyung Jung, M.D., Tae Hun Kim, M.D., Kwon Yoo, M.D. and Il-Hwan M
Korean J Gastrointest Endosc 2011;42(6):356-360.   Published online April 16, 2011
AbstractAbstract PDF
Background/Aims: Attempts to increase colonoscopy withdrawal time have been the topic of several recent publications. We assessed whether the real-time measurement of withdrawal time affected the withdrawal time and polyp detection rate. Methods: Real-time colonoscopy withdrawal time was measured in 197 subjects in a study group and 184 subjects comprised a control group without real-time measurements. Colonoscopies were performed by four endoscopy specialists and three fellows during their first year of training. Withdrawal time, clinical features, bowel preparation, and polyp detection rates were comparatively analyzed. Results: No significant differences in age, gender, bowel preparation, or polyp history were found in the two groups. Withdrawal time was significantly higher in the study group than that in the control group when a fellow performed the withdrawal. However, polyp detection rate did not significantly increase in the study group, regardless of physician. Conclusions: Real-time measurement of colonoscopy withdrawal time did not increase polyp detection rate, but the withdrawal time was significantly higher when a fellow performed the withdrawal phase than when a specialist performed withdrawal. Therefore, the real-time measurement of colonoscopy withdrawal time seems to be a useful tool for fellow training.
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Quality Control for Upper Gastrointestinal Endoscopy
Jae Myung Park, M.D.
Korean J Gastrointest Endosc 2010;40(6):343-346.   Published online June 30, 2010
AbstractAbstract PDF
Upper gastrointestinal endoscopy is the most common procedure in the field of gastroenterology. Controlling the quality of endoscopy is quite important because gastric cancer is the most prevalent cancer in Korea. For each endoscopic procedure, the indicators of quality control can be considered for 3 time periods: the preprocedure, intraprocedure and postprocedure periods. The common issues during preprocedure include the proper indications, the patient's consent for the procedure, the patient's clinical status and the risk assessment, and the steps to reduce the risk. The common issues during intraprocedure include all the technical aspects of the procedure, including completion of the examination and any of the therapeutic maneuvers. The postprocedure activities include providing instructions to the patient, documentation of the procedure, recognition and documentation of complications, follow-up of the pathologic conditions and assessing the patient's satisfaction. Regular monitoring the quality of endoscopy can raise the level of performing endoscopic procedures.(Korean J Gastrointest Endosc 2010;40:343-346)
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