Differences in Endoscopy Characteristics Between Providers With the Highest and Lowest Post Endoscopy Upper...

Area of Science:

• Gastroenterology
• Oncology
• Health Services Research

Background:

• Significant variation exists in post-endoscopy upper gastrointestinal cancer (PEUGIC) rates among endoscopy providers in England.
• Understanding the factors contributing to these rate disparities is crucial for improving diagnostic quality and patient outcomes.

Purpose of the Study:

• To investigate the association between specific endoscopy characteristics and the rates of PEUGIC.
• To identify modifiable factors that can help reduce PEUGIC and enhance the quality of endoscopic procedures.

Main Methods:

• Categorization of endoscopy providers into quartiles based on PEUGIC rates.
• Analysis of diagnostic upper gastrointestinal (UGI) endoscopy data from January 2019 to February 2020.
• Multivariable regression to identify endoscopy characteristics linked to lower PEUGIC rates, adjusting for patient factors and indications.

Main Results:

• Training sessions, intravenous sedation use, and higher annual endoscopist volumes (101-300) were positively associated with lower PEUGIC rates.
• Fewer biopsies, endoscopists not on specialty registers, and less intensive endoscopy sessions (average ≥ 9 points) were inversely associated with lower PEUGIC rates.
• Providers with lower PEUGIC rates demonstrated better compliance with national quality standards for biopsies in high-risk conditions.

Conclusions:

• Endoscopy training, adequate endoscopist volume, sedation use, and judicious biopsy practices are associated with reduced PEUGIC.
• These findings provide actionable insights for quality improvement initiatives aimed at lowering PEUGIC and enhancing endoscopy care.