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Liu Y, Gu K. Association between anesthesia assistance and precancerous lesions and early cancer detection during diagnostic esophagogastroduodenoscopy: a propensity score-matched retrospective study. Front Med (Lausanne) 2024; 11:1389809. [PMID: 39114825 PMCID: PMC11303204 DOI: 10.3389/fmed.2024.1389809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 07/15/2024] [Indexed: 08/10/2024] Open
Abstract
Background Esophagogastroduodenoscopy (EGD) is a fundamental procedure for early detection of upper gastrointestinal (UGI) cancer. However, limited research has been conducted on the impact of sedation during EGD on the identification of precancerous lesions and early cancer (EC). This retrospective study aims to evaluate whether sedation during EGD can improve the detection rates of precancerous lesions and EC. Methods In this propensity score-matched retrospective study, we examined medical records from outpatients who underwent diagnostic EGD at a large tertiary center between January 2023 and December 2023. Data on endoscopic findings and histology biopsies were obtained from an endoscopy quality-control system. The primary objective was to compare the rates of detecting precancerous lesions and EC in patients who received sedation during EGD vs. those who did not receive sedation. Additionally, we aimed to identify factors influencing these detection rates using binary logistic regression analysis. Results Following propensity score matching, a total of 17,862 patients who underwent diagnostic EGD with or without propofol sedation were identified. The group that received sedation exhibited a higher detection rate of precancerous lesions and EC in comparison to the non-sedated group (1.04 vs. 0.75%; p = 0.039). Additionally, within the sedated group, there was an increased likelihood of identifying precancerous lesions and EC specifically at the gastric antrum (0.60 vs. 0.32%, p = 0.006). Binary logistic regression analysis demonstrated that independent risk factors influencing the detection rates included age, gender, observation time, and number of biopsies conducted during the procedure. Conclusion Anesthesia assistance during EGD screening proved advantageous in detecting EC as well as precancerous lesions. It is crucial for endoscopists to consider these factors when performing EGD screening procedures.
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Affiliation(s)
| | - Kaier Gu
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
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2
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Zhou S, Chen Z, Jiao Y, Cheng Z, Gao Y, Wang T, Xin L, Wan R, Wang L. Development of esophagogastroduodenoscopy in China: results from the national census in 2013 and 2020. Front Oncol 2024; 14:1366706. [PMID: 38912062 PMCID: PMC11190165 DOI: 10.3389/fonc.2024.1366706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 05/20/2024] [Indexed: 06/25/2024] Open
Abstract
Background Given the significant burden of upper digestive diseases, there has been a substantial increase in the utilization of esophagogastroduodenoscopy (EGD) in China from 2012 to 2019. The objective of this study is to investigate the development, practice, and factors influencing the widespread use of EGD during this period. Methods Two national censuses were conducted among all hospitals in mainland China that perform gastrointestinal endoscopy. These censuses aimed to extract information on the infrastructure, volume, and quality of EGD. The analysis of potential factors influencing EGD practice was based on real-world data from open access sources. Results From 2012 to 2019, the number of hospitals performing EGD in mainland China increased from 1,518 to 2,265 (1.49-fold) in tertiary hospitals and from 3,633 to 4,097 (1.12-fold) in secondary hospitals, respectively. The national utilization rate of EGD also increased from 1,643.53 to 2,018.06 per 100,000 inhabitants, indicating a 1.23-fold increase. Regions with more endoscopists per 100,000 inhabitants (OR 9.61, P<0.001), more tertiary hospitals performing EGD per million inhabitants (OR 2.43, P<0.001), higher incidence of esophageal and gastric cancer (OR 2.09, P=0 016), and higher number of hospitals performing EGD per million inhabitants (OR 1.77, P=0.01) tended to provided more numerous and qualitied EGD. And hospital grading, regional GDP, incidence of esophageal and gastric cancer and the volume of EGD were observed as the significantly relevant factors of malignant dictation rate (MDR) (P<0.05), but not the number and educational background of endoscopists. Conclusion Over the past seven years, China has made significant progress in EGD. However, challenges persist in terms of quality and inequality.
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Affiliation(s)
- Siwei Zhou
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
- National Digestive Endoscopy Improvement System, Shanghai, China
| | - Zheran Chen
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
- National Digestive Endoscopy Improvement System, Shanghai, China
| | - Yunfei Jiao
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
- National Digestive Endoscopy Improvement System, Shanghai, China
| | - Zhiyuan Cheng
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
- National Digestive Endoscopy Improvement System, Shanghai, China
- Department of Gastroenterology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ye Gao
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
- National Digestive Endoscopy Improvement System, Shanghai, China
| | - Tianjiao Wang
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
- National Digestive Endoscopy Improvement System, Shanghai, China
| | - Lei Xin
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
- National Digestive Endoscopy Improvement System, Shanghai, China
| | - Rong Wan
- Department of Gastroenterology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Luowei Wang
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
- National Digestive Endoscopy Improvement System, Shanghai, China
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Li P, Li Z, Linghu E, Ji J. Chinese national clinical practice guidelines on the prevention, diagnosis, and treatment of early gastric cancer. Chin Med J (Engl) 2024; 137:887-908. [PMID: 38515297 PMCID: PMC11046028 DOI: 10.1097/cm9.0000000000003101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Gastric cancer is one of the most common malignant tumors in the digestive system in China. Few comprehensive practice guidelines for early gastric cancer in China are currently available. Therefore, we created the Chinese national clinical practice guideline for the prevention, diagnosis, and treatment of early gastric cancer. METHODS This clinical practice guideline (CPG) was developed in accordance with the World Health Organization's recommended process and with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) in assessing evidence quality. We used the Evidence to Decision framework to formulate clinical recommendations to minimize bias and increase transparency in the CPG development process. We used the Reporting Items for practice Guidelines in HealThcare (RIGHT) statement and the Appraisal of Guidelines for Research and Evaluation II (AGREE II) as reporting and conduct guidelines to ensure completeness and transparency of the CPG. RESULTS This CPG contains 40 recommendations regarding the prevention, screening, diagnosis, treatment, and follow-up of early gastric cancer based on available clinical studies and guidelines. We provide recommendations for the timing of Helicobacter pylori eradication, screening populations for early gastric cancer, indications for endoscopic resection and surgical gastrectomy, follow-up interval after treatment, and other recommendations. CONCLUSIONS This CPG can lead to optimum care for patients and populations by providing up-to-date medical information. We intend this CPG for widespread adoption to increase the standard of prevention, screening, diagnosis, treatment, and follow-up of early gastric cancer; thereby, contributing to improving national health care and patient quality of life.
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Affiliation(s)
- Peng Li
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Disease, Beijing 100050, China
| | - Ziyu Li
- Department of Gastrointestinal Surgery, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Enqiang Linghu
- Department of Gastroenterology and Hepatology, the First Medical Center, Chinese People’s Liberation Army General Hospital, Beijing 100853, China
| | - Jiafu Ji
- Department of Gastrointestinal Surgery, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing 100142, China
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Zhang L, Yao L, Lu Z, Yu H. Current status of quality control in screening esophagogastroduodenoscopy and the emerging role of artificial intelligence. Dig Endosc 2024; 36:5-15. [PMID: 37522555 DOI: 10.1111/den.14649] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 07/27/2023] [Indexed: 08/01/2023]
Abstract
Esophagogastroduodenoscopy (EGD) screening is being implemented in countries with a high incidence of upper gastrointestinal (UGI) cancer. High-quality EGD screening ensures the yield of early diagnosis and prevents suffering from advanced UGI cancer and minimal operational-related discomfort. However, performance varied dramatically among endoscopists, and quality control for EGD screening remains suboptimal. Guidelines have recommended potential measures for endoscopy quality improvement and research has been conducted for evidence. Moreover, artificial intelligence offers a promising solution for computer-aided diagnosis and quality control during EGD examinations. In this review, we summarized the key points for quality assurance in EGD screening based on current guidelines and evidence. We also outline the latest evidence, limitations, and future prospects of the emerging role of artificial intelligence in EGD quality control, aiming to provide a foundation for improving the quality of EGD screening.
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Affiliation(s)
- Lihui Zhang
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
- Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
| | - Liwen Yao
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
- Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
| | - Zihua Lu
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
- Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
| | - Honggang Yu
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
- Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
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Emura F. Missed gastric cancer: tackling the elephant in the room. Gastrointest Endosc 2023; 98:744-746. [PMID: 37863569 DOI: 10.1016/j.gie.2023.07.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 10/22/2023]
Affiliation(s)
- Fabian Emura
- Director, Advanced GI Endoscopy, EmuraCenter LatinoAmerica, Bogotá, Colombia; Chair, Gastroenterology Division, Universidad de La Sabana, Chía, Colombia
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Gao Y, Cai MX, Tian B, Lin H, Jiang ZY, Yang XC, Lu L, Li L, Shi LH, Liu XY, Wang YL, Li ZS, Xin L, Wang LW. Setting 6-Minute Minimal Examination Time Improves the Detection of Focal Upper Gastrointestinal Tract Lesions During Endoscopy: A Multicenter Prospective Study. Clin Transl Gastroenterol 2023; 14:e00612. [PMID: 37307142 PMCID: PMC10461959 DOI: 10.14309/ctg.0000000000000612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 06/02/2023] [Indexed: 06/14/2023] Open
Abstract
INTRODUCTION Positive correlation between examination time and neoplasm detection using esophagogastroduodenoscopy (EGD) has been described by observational studies, but the effect of setting minimal examination time still requires investigation. METHODS This prospective, 2-stage, interventional study was conducted in 7 tertiary hospitals in China, enrolling consecutive patients undergoing intravenously sedated diagnostic EGDs. In stage I, the baseline examination time was collected without informing the endoscopists. In stage II, the minimal examination time was set for the same endoscopist according to the median examination time of normal EGDs in stage I. The primary outcome was the focal lesion detection rate (FDR), defined as the proportion of subjects with at least one focal lesion among all subjects. RESULTS A total of 847 and 1,079 EGDs performed by 21 endoscopists were included in stages I and II, respectively. In stage II, the minimal examination time was set as 6 minutes, and the median time for normal EGD increased from 5.8 to 6.3 minutes ( P < 0.001). Between the 2 stages, the FDR was significantly improved (33.6% vs 39.3%, P = 0.011), and the effect of the intervention was significant (odds ratio, 1.25; 95% confidence interval, 1.03-1.52; P = 0.022) even after adjusting for subjects' age, smoking status, endoscopists' baseline examination time, and working experience. The detection rate of high-risk lesions (neoplastic lesions and advanced atrophic gastritis) was also significantly higher in stage II (3.3% vs 5.4%, P = 0.029). In the endoscopist-level analysis, all practitioners reached a median examination time of 6 minutes, and the coefficients of variation of FDR (36.9%-26.2%) and examination time (19.6%-6.9%) decreased in stage II. DISCUSSION Setting a 6-minute minimal examination time significantly improved the detection of focal lesions during EGDs and has the potential to be implemented for quality improvement.
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Affiliation(s)
- Ye Gao
- Digestive Endoscopy Center, Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
- National Digestive Endoscopy Improvement System, Shanghai, China
| | - Meng-Xi Cai
- Digestive Endoscopy Center, Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
- National Digestive Endoscopy Improvement System, Shanghai, China
| | - Bo Tian
- Digestive Endoscopy Center, Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
- National Digestive Endoscopy Improvement System, Shanghai, China
| | - Han Lin
- Digestive Endoscopy Center, Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
- National Digestive Endoscopy Improvement System, Shanghai, China
| | - Zhen-Yu Jiang
- Department of Gastroenterology, The Second Affiliated Hospital of Baotou Medical College, Baotou, Inner Mongolia, China
| | - Xiao-Cui Yang
- Department of Gastroenterology, Ankang Central Hospital, Ankang, Shaanxi, China
| | - Lin Lu
- Department of Gastroenterology, Linyi People's Hospital, Linyi, Shandong, China
| | - Li Li
- Digestive Endoscopy Center, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Li-Hong Shi
- Department of Gastroenterology, the Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Xiao-Yu Liu
- Department of Gastroenterology, Yulin No. 2 hospital, Yulin, Shaanxi, China
| | - Yi-Lin Wang
- Georgetown Preparatory School, North Bethesda, MD, USA
| | - Zhao-Shen Li
- Digestive Endoscopy Center, Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
- National Digestive Endoscopy Improvement System, Shanghai, China
| | - Lei Xin
- Digestive Endoscopy Center, Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
- National Digestive Endoscopy Improvement System, Shanghai, China
| | - Luo-Wei Wang
- Digestive Endoscopy Center, Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
- National Digestive Endoscopy Improvement System, Shanghai, China
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Namasivayam V, Uedo N. Quality indicators in the endoscopic detection of gastric cancer. DEN OPEN 2023; 3:e221. [PMID: 37051139 PMCID: PMC10083214 DOI: 10.1002/deo2.221] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 02/10/2023] [Accepted: 02/26/2023] [Indexed: 04/14/2023]
Abstract
Gastroscopy is the reference standard for the diagnosis of gastric cancer, but it is operator-dependent and associated with missed gastric cancer. The proliferation of gastroscopic examinations, increasingly for the screening and detection of subtle premalignant lesions, has motivated scrutiny of quality in gastroscopy. The concept of a high-quality endoscopic examination for the detection of superficial gastric neoplasia has been defined by expert guidelines to improve mucosal visualization, engender a systematic examination process and detect superficial neoplasia. This review discusses the evidence supporting the components of a high-quality diagnostic gastroscopic examination in relation to the detection of gastric cancer, and their potential role as procedural quality indicators to drive a structured improvement in clinically meaningful outcomes.
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Affiliation(s)
| | - Noriya Uedo
- Department of Gastrointestinal OncologyOsaka International Cancer InstituteOsakaJapan
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Liang M, Xu C, Zhang X, Zhang Z, Cao J. Effect of anesthesia assistance on the detection rate of precancerous lesions and early esophageal squamous cell cancer in esophagogastroduodenoscopy screening: A retrospective study based on propensity score matching. Front Med (Lausanne) 2023; 10:1039979. [PMID: 37035346 PMCID: PMC10078984 DOI: 10.3389/fmed.2023.1039979] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 02/28/2023] [Indexed: 04/11/2023] Open
Abstract
Background Esophagogastroduodenoscopy (EGD) screening is vital for the early diagnosis of esophageal squamous cell cancer (ESCC). However, improvement in the detection rate of precancerous lesions and early ESCC with anesthesia assistance (AA) has not yet been investigated. This retrospective study aimed to evaluate the effect of AA on the detection rate of precancerous lesions and early ESCC in patients undergoing EGD screening and identify risk factors affecting the detection rate. Methods We reviewed patients' electronic medical records who underwent EGD screening between May 2019 and August 2020. Patients were divided into two groups based on whether they received AA: those in Group A underwent EGD screening with AA, and patients in Group O underwent EGD screening without AA. Propensity score matching (PSM) was used to account for differences in baseline characteristics. Detection rates of precancerous lesions and early ESCC were compared between the two groups following PSM. Binary logistic regression was used to identify risk factors affecting the detection rate. Results The final analysis included 21,835 patients (Group A = 13,319, Group O = 8,516) from 28,985 patients who underwent EGD screening during the study period. Following PSM, 6009 patients remained in each group for analysis. There was no significant difference in the detection rate of precancerous lesions and early ESCC between Groups A and O (1.1% vs. 0.8%, p > 0.05). Binary logistic regression showed that age (50-59 years, 60-69 years and 70-79 years), higher endoscopist seniority, high-definition (HD) endoscopy, narrow-band imaging (NBI), and number of endoscopic images were all independent risk factors that affected the detection rate of precancerous lesions and early ESCC. Conclusion There was no statistically significant difference in the detection rate of precancerous lesions and early ESCC between patients who underwent EGD screening with and without AA. All independent risk factors that affected the detection rate of precancerous lesions and early ESCC included the following: age (50-59 years, 60-69 years and 70-79 years), higher endoscopist seniority, HD endoscopy, NBI, and number of endoscopic images. Endoscopists should consider all these factors as much as possible when performing EGD screening.
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Affiliation(s)
- Min Liang
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, China
- Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application Technology, Xuzhou Medical University, Xuzhou, China
- Department of Anesthesiology, Liaocheng People’s Hospital, Liaocheng, Shandong, China
| | - Chunhong Xu
- Department of Astroenterology, Liaocheng People’s Hospital, Liaocheng, Shandong, China
| | - Xinyan Zhang
- Department of Pathology, Liaocheng People’s Hospital, Liaocheng, Shandong, China
| | - Zongwang Zhang
- Department of Anesthesiology, Liaocheng People’s Hospital, Liaocheng, Shandong, China
- *Correspondence: Zongwang Zhang,
| | - Junli Cao
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, China
- Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application Technology, Xuzhou Medical University, Xuzhou, China
- Department of Anesthesiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Junli Cao,
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Ferreira CN, Serrazina J, Marinho RT. Detection and Characterization of Early Gastric Cancer. Front Oncol 2022; 12:855216. [PMID: 35936695 PMCID: PMC9354496 DOI: 10.3389/fonc.2022.855216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 06/10/2022] [Indexed: 11/30/2022] Open
Abstract
In this review, we would like to focus on risk stratification and quality indicators of diagnostic upper gastrointestinal endoscopy in the detection and characterization of early gastric cancer. Preparation of the upper gastrointestinal tract with mucolytic agents or simethicone is often overlooked in the west, and this inexpensive step prior to endoscopy can greatly improve the quality of imaging of the upper digestive tract. Risk stratification based on epidemiological features including family history, Helicobacter pylori infection status, and tobacco smoking is often overlooked but may be useful to identify a subgroup of patients at higher risk of developing gastric cancer. Quality indicators of diagnostic upper gastrointestinal endoscopy are now well defined and include: minimal inspection time of 3 min, adequate photographic documentation of upper gastrointestinal landmarks, utilization of advanced endoscopic imaging technology including narrow band imaging and blue laser imaging to detect intestinal metaplasia and characterize early gastric cancer; and standardized biopsy protocols allow for histological evaluation of gastric mucosa and detection of atrophic gastritis and intestinal metaplasia. Finally, endoscopic and histologic classifications such as the Kimura–Takemoto Classification of atrophic gastritis and the OLGA–OLGIM classifications may help stratify patients at a higher risk of developing early gastric cancer.
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Affiliation(s)
- Carlos Noronha Ferreira
- Serviço de Gastrenterologia e Hepatologia, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
- Clínica Universitária de Gastrenterologia, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- *Correspondence: Carlos Noronha Ferreira,
| | - Juliana Serrazina
- Serviço de Gastrenterologia e Hepatologia, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - Rui Tato Marinho
- Serviço de Gastrenterologia e Hepatologia, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
- Clínica Universitária de Gastrenterologia, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
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Kim SY, Park JM. Quality indicators in esophagogastroduodenoscopy. Clin Endosc 2022; 55:319-331. [PMID: 35656624 PMCID: PMC9178133 DOI: 10.5946/ce.2022.094] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 04/22/2022] [Indexed: 11/25/2022] Open
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.
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Affiliation(s)
- Sang Yoon Kim
- Department of Internal Medicine, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea
| | - 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, Seoul, Korea
- Catholic Photomedicine Research Institute, The Catholic University of Korea, Seoul, Korea
- Correspondence: 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, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea E-mail:
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Yokota Y, Iwatsubo T, Takeuchi T, Hakoda A, Nakagawa Y, Kawabata K, Inoue Y, Miyamoto H, Ikeo K, Kojima Y, Miyazaki J, Abe T, Higuchi K. Effects of a novel endoscopic reporting system with voice recognition on the endoscopic procedure time and report preparation time: propensity score matching analysis. J Gastroenterol 2022; 57:1-9. [PMID: 34694471 DOI: 10.1007/s00535-021-01835-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 10/20/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND With the increase in endoscopic procedures, endoscopists are spending more time creating reports. Although medical reports have largely become electronic, most of the current reporting systems require manual operation. This study aimed to evaluate the efficacy of a novel endoscopic reporting system that uses voice recognition (VR) technology. METHODS We retrospectively reviewed consecutive patients who underwent esophagogastroduodenoscopy between September 2019 and March 2020 at a general hospital in Japan. The novel reporting system, used during endoscopic procedures, is equipped with VR and provides automatic responses by playing back recognized words. Differences in total time spent on the endoscopic procedure and report preparation between the manual entry (ME) and VR groups were evaluated using a propensity score matching method. RESULTS We enrolled 356 patients: 226 and 130 patients in the ME and VR groups, respectively. Propensity score matching created 101 matched pairs. After matching, the median report preparation time (311 vs. 383 s, P = 0.009) and median total time (765 vs. 842 s, P = 0.053) in the VR group were shorter than those in the ME group. The VR system independently shortened the total and report preparation times by 156 s (95% confidence interval, - 274 to - 37 s; P = 0.009) and 118 s (95% confidence interval, - 220 to - 15 s; P = 0.023), respectively, on multiple linear regression analysis. CONCLUSIONS The VR system could save the report preparation time and the total time. This novel system may improve the efficiency of endoscopy-related tasks.
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Affiliation(s)
- Yuta Yokota
- Department of Gastroenterology, Hanwa Sumiyoshi General Hospital, Osaka, Japan
| | - Taro Iwatsubo
- 2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Toshihisa Takeuchi
- Endoscopic Center, Osaka Medical and Pharmaceutical University Hospital, Osaka, Japan.
| | - Akitoshi Hakoda
- Department of Gastroenterology, Hanwa Sumiyoshi General Hospital, Osaka, Japan
- 2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Yasuki Nakagawa
- Department of Gastroenterology, Hanwa Sumiyoshi General Hospital, Osaka, Japan
| | - Kazumi Kawabata
- Department of Gastroenterology, Hanwa Sumiyoshi General Hospital, Osaka, Japan
| | - Yuma Inoue
- Department of Gastroenterology, Hanwa Sumiyoshi General Hospital, Osaka, Japan
| | - Hayato Miyamoto
- Department of Gastroenterology, Hanwa Sumiyoshi General Hospital, Osaka, Japan
| | - Koichi Ikeo
- Department of Gastroenterology, Hanwa Sumiyoshi General Hospital, Osaka, Japan
| | - Yuichi Kojima
- Endoscopic Center, Osaka Medical and Pharmaceutical University Hospital, Osaka, Japan
| | - Junichi Miyazaki
- Department of Gastroenterology, Hanwa Sumiyoshi General Hospital, Osaka, Japan
| | - Takashi Abe
- Department of Gastroenterology, Hanwa Sumiyoshi General Hospital, Osaka, Japan
| | - Kazuhide Higuchi
- 2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan
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The effect of sedation on EGD inspection time. Gastrointest Endosc 2021; 94:875-876. [PMID: 34530977 DOI: 10.1016/j.gie.2021.05.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 05/06/2021] [Indexed: 12/11/2022]
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Kim SY, Park JM. Response. Gastrointest Endosc 2021; 94:876. [PMID: 34530978 DOI: 10.1016/j.gie.2021.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 06/05/2021] [Indexed: 12/11/2022]
Affiliation(s)
- Sang Yoon Kim
- Division of Gastroenterology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Jae Myung Park
- Division of Gastroenterology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
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Park JM. Quality Indicator for Gastric Cancer Detection Based on Helicobacter pylori Status. Clin Endosc 2020; 53:629-630. [PMID: 33271012 PMCID: PMC7719422 DOI: 10.5946/ce.2020.270] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 10/16/2020] [Indexed: 12/12/2022] Open
Affiliation(s)
- 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, Seoul, Korea.,Catholic Photomedicine Research Institute, The Catholic University of Korea, Seoul, Korea
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