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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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Autores principales: Ku, Lawrence, Hou, Linda A., Eysselein, Viktor E., Reicher, Sofiya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7915683/
https://www.ncbi.nlm.nih.gov/pubmed/33557251
http://dx.doi.org/10.3390/diagnostics11020242
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author Ku, Lawrence
Hou, Linda A.
Eysselein, Viktor E.
Reicher, Sofiya
author_facet Ku, Lawrence
Hou, Linda A.
Eysselein, Viktor E.
Reicher, Sofiya
author_sort Ku, Lawrence
collection PubMed
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) (p = 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.
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spelling pubmed-79156832021-03-01 Endoscopic Ultrasound Quality Metrics in Clinical Practice Ku, Lawrence Hou, Linda A. Eysselein, Viktor E. Reicher, Sofiya Diagnostics (Basel) Article 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) (p = 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. MDPI 2021-02-04 /pmc/articles/PMC7915683/ /pubmed/33557251 http://dx.doi.org/10.3390/diagnostics11020242 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ku, Lawrence
Hou, Linda A.
Eysselein, Viktor E.
Reicher, Sofiya
Endoscopic Ultrasound Quality Metrics in Clinical Practice
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 Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7915683/
https://www.ncbi.nlm.nih.gov/pubmed/33557251
http://dx.doi.org/10.3390/diagnostics11020242
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