Endoscopic Ultrasound Quality Metrics in Clinical Practice
Recent advances in endoscopic ultrasound (EUS), particularly EUS-guided tissue acquisition, may have affected EUS procedural performance as measured by current American Society for Gastrointestinal Endoscopy (ASGE)/American College of Gastroenterology (ACG) quality indicators. Our study aims to asse...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-02-01
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| Series: | Diagnostics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2075-4418/11/2/242 |
| _version_ | 1797415124244365312 |
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| author | Lawrence Ku Linda A. Hou Viktor E. Eysselein Sofiya Reicher |
| author_facet | Lawrence Ku Linda A. Hou Viktor E. Eysselein Sofiya Reicher |
| author_sort | Lawrence Ku |
| collection | DOAJ |
| description | Recent advances in endoscopic ultrasound (EUS), particularly EUS-guided tissue acquisition, may have affected EUS procedural performance as measured by current American Society for Gastrointestinal Endoscopy (ASGE)/American College of Gastroenterology (ACG) quality indicators. Our study aims to assess how these quality metrics are met in clinical practice. We retrospectively analyzed 732 EUS procedures; data collected were procedural indications, technical aspects and outcomes, completeness of documentation, and malignancy staging. EUS was performed in 660 patients for a variety of indications. All ASGE/ACG EUS procedural quality metrics were met or exceeded. Intervention was successful in 97.7% (715/732) of cases, with complication rate of 0.4% (3/732). EUS outcomes changed clinical management in 58.7% of all cases and in 91.2% of malignancy work-up cases; in 26.0% of suspected choledocholithiasis cases, endoscopic retrograde cholangiopancreatography (ERCP) was avoided after EUS. Locoregional EUS staging was accurate in 61/65 (93.8%) cases of non-metastatic disease and in 15/22 (68.2%) cases of metastatic disease. Pancreatic mass malignancy detection rate with EUS-guided fine needle aspiration (FNA) or fine needle biopsy (FNB) was 75.8%, with a sensitivity of 96.2%; a significant increase in detection rate from 46.2% (6/13) to 95.0% (19/20) (<i>p</i> = 0.0026) was observed with a transition to the predominant use of FNB for tissue acquisition. All ASGE/ACG EUS quality metrics were met or exceeded for EUS procedures performed for a wide variety of indications in a diverse patient population. EUS was instrumental in changing clinical management, with a low complication rate. The malignancy detection rate in pancreatic masses significantly increased with FNB use. |
| first_indexed | 2024-03-09T05:44:22Z |
| format | Article |
| id | doaj.art-a044be360b1946f4875819acdfc9c7d1 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-09T05:44:22Z |
| publishDate | 2021-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-a044be360b1946f4875819acdfc9c7d12023-12-03T12:22:57ZengMDPI AGDiagnostics2075-44182021-02-0111224210.3390/diagnostics11020242Endoscopic Ultrasound Quality Metrics in Clinical PracticeLawrence Ku0Linda A. Hou1Viktor E. Eysselein2Sofiya Reicher3Division of Gastroenterology, Harbor-UCLA Medical Center, Torrance, CA 90502, USADivision of Gastroenterology, Harbor-UCLA Medical Center, Torrance, CA 90502, USADivision of Gastroenterology, Harbor-UCLA Medical Center, Torrance, CA 90502, USADivision of Gastroenterology, Harbor-UCLA Medical Center, Torrance, CA 90502, USARecent advances in endoscopic ultrasound (EUS), particularly EUS-guided tissue acquisition, may have affected EUS procedural performance as measured by current American Society for Gastrointestinal Endoscopy (ASGE)/American College of Gastroenterology (ACG) quality indicators. Our study aims to assess how these quality metrics are met in clinical practice. We retrospectively analyzed 732 EUS procedures; data collected were procedural indications, technical aspects and outcomes, completeness of documentation, and malignancy staging. EUS was performed in 660 patients for a variety of indications. All ASGE/ACG EUS procedural quality metrics were met or exceeded. Intervention was successful in 97.7% (715/732) of cases, with complication rate of 0.4% (3/732). EUS outcomes changed clinical management in 58.7% of all cases and in 91.2% of malignancy work-up cases; in 26.0% of suspected choledocholithiasis cases, endoscopic retrograde cholangiopancreatography (ERCP) was avoided after EUS. Locoregional EUS staging was accurate in 61/65 (93.8%) cases of non-metastatic disease and in 15/22 (68.2%) cases of metastatic disease. Pancreatic mass malignancy detection rate with EUS-guided fine needle aspiration (FNA) or fine needle biopsy (FNB) was 75.8%, with a sensitivity of 96.2%; a significant increase in detection rate from 46.2% (6/13) to 95.0% (19/20) (<i>p</i> = 0.0026) was observed with a transition to the predominant use of FNB for tissue acquisition. All ASGE/ACG EUS quality metrics were met or exceeded for EUS procedures performed for a wide variety of indications in a diverse patient population. EUS was instrumental in changing clinical management, with a low complication rate. The malignancy detection rate in pancreatic masses significantly increased with FNB use.https://www.mdpi.com/2075-4418/11/2/242endoscopic ultrasonographyquality indicatorshealthcarefine needle biopsy |
| spellingShingle | Lawrence Ku Linda A. Hou Viktor E. Eysselein Sofiya Reicher Endoscopic Ultrasound Quality Metrics in Clinical Practice Diagnostics endoscopic ultrasonography quality indicators healthcare fine needle biopsy |
| title | Endoscopic Ultrasound Quality Metrics in Clinical Practice |
| title_full | Endoscopic Ultrasound Quality Metrics in Clinical Practice |
| title_fullStr | Endoscopic Ultrasound Quality Metrics in Clinical Practice |
| title_full_unstemmed | Endoscopic Ultrasound Quality Metrics in Clinical Practice |
| title_short | Endoscopic Ultrasound Quality Metrics in Clinical Practice |
| title_sort | endoscopic ultrasound quality metrics in clinical practice |
| topic | endoscopic ultrasonography quality indicators healthcare fine needle biopsy |
| url | https://www.mdpi.com/2075-4418/11/2/242 |
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