Defining and measuring endoscopic complications: more questions than answers

The demand for information on quality in health care has risen sharply over the past decade. Endoscopic outcomes, including complication rates, need to be accurately measured and reported. Such documentation continues to be problematic because of the lack of a widely accepted classification system for endoscopic complications. Such a system should (1) include unequivocal definitions for the various types of negative outcomes and categories of complications; (2) define what negative outcomes are to be classified as complications, and (3) standardize the stratification of complications by severity. Establishing such a standardized classification of endoscopic complications could facilitate clinical research, improve the position of gastroenterologists vis-à-vis pay-for-performance programs, and result in better and more meaningful quality improvement programs, ultimately improving the care provided to patients.