Literature DB >> 28066945

Examination time as a quality indicator of screening upper gastrointestinal endoscopy for asymptomatic examinees.

Takuji Kawamura1, Hironori Wada1, Naokuni Sakiyama1, Yuki Ueda1, Atsushi Shirakawa1, Yusuke Okada1, Kasumi Sanada1, Kojiro Nakase1, Koichiro Mandai1, Azumi Suzuki1, Mai Kamaguchi2, Atsuhiro Morita1, Kenichi Nishioji2, Kiyohito Tanaka1, Naomi Mochizuki2, Koji Uno1, Isao Yokota3, Masao Kobayashi2, Kenjiro Yasuda1.   

Abstract

BACKGROUND AND AIM: The significance of examination time of esophagogastroduodenoscopy (EGD) for asymptomatic examinees is yet to be established. We aimed to clarify whether endoscopists who allot more examination time can detect higher numbers of neoplastic lesions among asymptomatic examinees.
METHODS: We reviewed a database of consecutive examinees who underwent EGD in our hospital from April 2010 to September 2015. Staff endoscopists were classified into fast, moderate, and slow groups based on the mean examination time of EGD without a biopsy. Neoplastic lesion detection rate among these groups was compared using multiple logistic regression.
RESULTS: Of the 55 786 consecutive examinees who underwent EGD, 15 763 asymptomatic examinees who were screened by staff doctors were analyzed. Mean examination time of 13 661 EGD without biopsy was 6.2 min (range, 2-18 min). When cut-off times of 5 and 7 min were used, four endoscopists were classified into the fast (mean duration, 4.4 ± 1.0 min), 12 into the moderate (6.1 ± 1.4 min), and four into the slow (7.8 ± 1.9 min) groups. Neoplastic lesion detection rates in the fast, moderate, and slow groups were 0.57% (13/2288), 0.97% (99/10 180), and 0.94% (31/3295), respectively. Compared with that in the fast group, odds ratios for the neoplastic lesion detection rate in the moderate and slow groups were 1.90 (95% confidence interval [CI], 1.06-3.40) and 1.89 (95% CI, 0.98-3.64), respectively.
CONCLUSION: Endoscopists who do not allot adequate examination time may overlook neoplastic lesions in the upper gastrointestinal tract.
© 2017 Japan Gastroenterological Endoscopy Society.

Entities:  

Keywords:  cancer screening; endoscopy; esophageal cancer; gastric cancer; quality indicator

Mesh:

Year:  2017        PMID: 28066945     DOI: 10.1111/den.12804

Source DB:  PubMed          Journal:  Dig Endosc        ISSN: 0915-5635            Impact factor:   7.559


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