Endoscopic biopsy as quality assurance for endoscopic services

Area of Science:

• Gastroenterology
• Endoscopy Quality Assurance

Background:

• Gastroendoscopy (GS) is performed by gastroenterologists (GE) and hepatologists (HT).
• Endoscopic biopsy (EBx) is crucial for diagnosing gastrointestinal pathology but its utilization varies.
• Endoscopist skill and experience influence EBx quality, impacting service quality.

Purpose of the Study:

• To assess the EBx/GS ratio as an index for endoscopic quality assurance.
• To compare EBx utilization between GE and HT in a teaching hospital setting.

Main Methods:

• A 14.5-year cohort study at Kaohsiung Chang Gung Memorial Hospital.
• Analyzed 34,570 EBx procedures within 199,877 GS procedures across 25 endoscopists (13 GE, 12 HT).
• Calculated EBx/GS ratio and Pearson correlation coefficients.

Main Results:

• The overall EBx/GS ratio was 19.29% with a high Pearson correlation of 0.90229.
• Gastroenterologists (GE) had significantly higher EBx/GS ratios than hepatologists (HT) at 1 and 5 years (21.5% vs. 15.1% and 20.9% vs. 17.3%).
• Junior GE performed significantly more EBx than senior GE and junior HT.

Conclusions:

• The EBx/GS ratio is a valuable tool for ensuring the quality of gastrointestinal endoscopic procedures in teaching hospitals.
• Variations in EBx utilization exist between specialties and experience levels, highlighting areas for quality improvement.
• Comprehensive quality assurance in endoscopy encompasses unit management and patient safety.