Quality indicatorsQuality indicators for capsule endoscopy and deep enteroscopy
Section snippets
Methods
This report describes new data pertaining to quality indicators for CE and DE. Indicators with wide-ranging clinical applications are prioritized as are those associated with practice variations and outcomes. Whenever possible, we focus on quality indicators validated in clinical studies. The RAND/University of California Los Angeles Appropriateness Method (RAM) was used to develop quality indicators for CE and DE to be used for patients with suspected small-bowel disease.6 Based on RAM, an
Preprocedure
- 1.
Frequency of demonstrating competency in CE
Type of measure: process
Performance target: 100%
Evidence summary: Formal training in CE can be obtained during fellowship or postgraduate and subspecialty-society–sponsored courses. As for any endoscopic procedure, a minimum standard of performance is required for an endoscopist to be deemed competent, understanding that learners may achieve competency after different numbers of CE studies performed. Multiple society guidelines recommend a minimum
Preprocedure
- 1.
Frequency of demonstrating competency in DE
Type of measure: process
Performance target: 100%
Evidence summary: Limited data exist regarding training requirements for DE, which is labor-intensive with a steep learning curve. The procedure requires a unique set-up and instruments and a trained, skilled nurse/technologist or team. Two studies using balloon enteroscopy reported that procedural time and small-bowel extent visualized improves after 10 to 15 procedures.72,73 In a single-center study of
Conclusion
CE and DE have an important positive impact on the diagnosis and management of small-bowel diseases. However, comprehensive quality indicators for CE and DE performance have been lacking, despite previous efforts to create individual quality metrics. The task force hoped to improve the quality performance of these relatively new small-bowel diagnostic techniques by compiling comprehensive recommendations of quality indicators for CE and DE procedures. Incorporating the measures into clinical
References (140)
- et al.
ASGE guideline: guidelines for credentialing and granting privileges for capsule endoscopy
Gastrointest Endosc
(2005) - et al.
Guidelines for privileging, credentialing, and proctoring to perform GI endoscopy
Gastrointest Endosc
(2017) Quality assurance for endoscopists
Best Pract Res Clin Gastroenterol
(2011)- et al.
Quality indicators common to all GI endoscopic procedures
Gastrointest Endosc
(2015) - et al.
Quality indicators for EUS
Gastrointest Endosc
(2015) - et al.
Training in small-bowel capsule endoscopy: assessing and defining competency
Gastrointest Endosc
(2013) - et al.
Prospective multicenter study to evaluate capsule endoscopy competency using a validated assessment tool
Gastrointest Endosc
(2020) - et al.
Appropriate use of GI endoscopy
Gastrointest Endosc
(2012) - et al.
Clinical practice guidelines for the use of video capsule endoscopy
Gastroenterology
(2017) - et al.
Indications and detection, completion, and retention rates of small-bowel capsule endoscopy: a systematic review
Gastrointest Endosc
(2010)
The role of endoscopy in the management of obscure GI bleeding
Gastrointest Endosc
Video capsule endoscopy: technology, reading, and troubleshooting
Gastrointest Endosc Clin North Am
Safety and efficacy of wireless capsule endoscopy in patients with surgically altered upper gastrointestinal anatomy
Laparosc Endosc Robot Surg
Performance of the patency capsule compared with nonenteroclysis radiologic examinations in patients with known or suspected intestinal strictures
Gastrointest Endosc
Prediction of patency capsule retention in known Crohn's disease patients by using magnetic resonance imaging
Gastrointest Endosc
Timing of video capsule endoscopy relative to overt obscure GI bleeding: implications from a retrospective study
Gastrointest Endosc
Use of capsule endoscopy in the emergency department as a triage of patients with GI bleeding
Gastrointest Endosc
A re-review of caspule endoscopies of patients referred for deep enteroscopy changes their management
Gastrointest Interv
Evaluations of capsule endoscopy software in reducing the reading time and the rate of false negatives by inexperienced endoscopists
Clin Res Hepatol Gastroenterol
Can we shorten the small-bowel capsule reading time with the "Quick-view" image detection system?
Dig Liver Dis
Can we reduce capsule endoscopy reading times?
Gastrointest Endosc
Acute small-bowel perforation secondary to capsule endoscopy
Gastrointest Endosc
A prospective study of the utility of abdominal radiographs after capsule endoscopy for the diagnosis of capsule retention
Gastrointest Endosc
What is the learning curve associated with double-balloon enteroscopy? Technical details and early experience in 6 U.S. Tertiary care centers
Gastrointest Endosc
Initial experience with double-balloon enteroscopy at a US center
Gastrointest Endosc
Single-balloon enteroscopy
Gastrointest Endosc Clin North Am
Effective dilation of small-bowel strictures by double-balloon enteroscopy in patients with symptomatic Crohn's disease (with video)
Gastrointest Endosc
Double-balloon endoscopy as the primary method for small-bowel video capsule endoscope retrieval
Gastrointest Endosc
Long-term outcomes after double-balloon enteroscopy for obscure gastrointestinal bleeding
Clin Gastroenterol Hepatol
Response
Gastrointest Endosc
Provocative mesenteric angiography for lower gastrointestinal hemorrhage: results from a single-institution study
J Vasc Interv Radiol
Antegrade is more effective than retrograde enteroscopy for evaluation and management of suspected small-bowel disease
Clin Gastroenterol Hepatol
Double-balloon enteroscopy (push-and-pull enteroscopy) of the small bowel: feasibility and diagnostic and therapeutic yield in patients with suspected small bowel disease
Gastrointest Endosc
Clinical outcomes of double-balloon endoscopy for the diagnosis and treatment of small-intestinal diseases
Clin Gastroenterol Hepatol
The urgent need to improve health care quality: Institute of medicine national roundtable on health care quality
JAMA
The RAND/UCLA appropriateness method user's manual
Quality indicators for ERCP
Am J Gastroenterol
Performance measures for small-bowel endoscopy: a European society of gastrointestinal endoscopy (ESGE) quality improvement initiative
Endoscopy
Curriculum for small-bowel capsule endoscopy and device-assisted enteroscopy training in europe: European society of gastrointestinal endoscopy (ESGE) position statement
Endoscopy
Small-bowel capsule endoscopy and device-assisted enteroscopy for diagnosis and treatment of small-bowel disorders: European society of gastrointestinal endoscopy (ESGE) clinical guideline
Endoscopy
Small-bowel capsule endoscopy and device-assisted enteroscopy for diagnosis and treatment of small-bowel disorders: European society of gastrointestinal endoscopy (ESGE) technical review
Endoscopy
The yield of capsule endoscopy in patients with abdominal pain or diarrhea
Endoscopy
Contraindications for video capsule endoscopy
World J Gastroenterol
Findings in patients with chronic intestinal dysmotility investigated by capsule endoscopy
BMC Gastroenterol
Retention associated with video capsule endoscopy: systematic review and meta-analysis
Gastrointest Endosc
Capsule retentions and incomplete capsule endoscopy examinations: an analysis of 2300 examinations
Gastroenterol Res Pract
Capsule retention in Crohn's disease: a meta-analysis
Inflamm Bowel Dis
Value of the patency capsule in pre-evaluation for capsule endoscopy in cases of intestinal obstruction
J Dig Dis
Symptomatic retention of the patency capsule: a multicenter real life case series
Endosc Int Open
Capsule endoscopy for small-intestinal disorders: current status
Dig Endosc
Cited by (0)
DISCLOSURE: The following authors disclosed financial relationships: J. A. Leighton: Consultant for Medtronic, Olympus America, and Check-Cap Ltd. D. J. Hass: Consultant and speaker for Medtronic. N. M. Guda: Consultant for Boston Scientific Corporation and Hemostasis LLC, Minneapolis. All other authors disclosed no financial relationships.
This article is being published jointly in Gastrointestinal Endoscopy and The American Journal of Gastroenterology. The article is identical except for minor stylistic and spelling differences in keeping with each journal's style. Citations from either journal can be used when citing this article.