Quality Indicators for EGD

Walter G Park MD, MS; Nicholas J Shaheen MD, MPH; Jonathan Cohen MD; Irving M Pike MD; Douglas G Adler MD; John M Inadomi MD; Loren A Laine MD; John G Lieb MD; Maged K Rizk MD; Mandeep S Sawhney MD, MS; Sachin Wani MD


Am J Gastroenterol. 2015;110(1):60-71. 

In This Article


This update on quality indicators for EGD incorporates new information to provide a relevant list for endoscopists who want to perform high-quality upper endoscopy. Similar to those from the original version published in 2006, the indicators are classified as preprocedure, intra-procedure, and postprocedure indicators, and this is summarized in Table 4. The proposed indicators vary in the level of supporting evidence, and several are based solely on expert opinion. For practical and ethical reasons, some indicators may be impossible to validate, such as performing and documenting informed consent and patient monitoring during moderate sedation. The absence of evidence does not equate to evidence of no benefit.

For EGD, the proposed quality measures are predominantly process measures. Many of these process measures are good surrogates of outcomes, based on evidence that links them to clinically recognized outcomes. The future direction of quality indicator development will include relevant outcome measures and a more robust evidence base to support proposed performance targets. The proposed research questions address this deficit of evidence.