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Gastroenterol Hepatol ; 43(10): 589-597, 2020 Dec.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-32674879

RESUMO

INTRODUCTION: In a previous study we demonstrated that a simple training programme improved quality indicators of Oesophagogastroduodenoscopy (OGD) achieving the recommended benchmarks. However, the long-term effect of this intervention is unknown. The aim of this study was to assess the quality of OGDs performed 3 years after of having completed a training programme. MATERIAL AND METHODS: A comparative study of 2 cohorts was designed as follows: Group A included OGDs performed in 2016 promptly after a training programme and Group B with OGDs performed from January to March 2019, this group was also divided into 2 subgroups: subgroup B1 of Endoscopists who had participated in the previous training programme and subgroup B2 of Endoscopists who had not. The intra-procedure quality indicators proposed by ASGE-ACG were used. RESULTS: A total of 1236 OGDs were analysed, 600 from Group A and 636 from Group B (439 subgroup B1 and 197 subgroup B2). The number of complete examinations was lower in Group B (566 [94.3%] vs. 551 [86.6%]; p<0.001). A significant decrease was observed in nearly all quality indicators and they did not reach the recommended benchmarks: retroflexion in the stomach (96% vs. 81%; p<0.001); Seattle biopsy protocol (86% vs. 50%; p=0.03), description of the upper GI bleeding lesion (100% vs. 62%; p<0.01), sufficient intestinal biopsy specimens (at least 4) in suspected coeliac disease (92.5% vs. 18%; p<0.001), photo documentation of the lesion (94% vs. 90%; p<0.05). Regarding the overall assessment of the procedure (including correct performance and adequate photo documentation), a significant decrease was also observed (90.5% vs. 62%; p<0.001). There were no differences between subgroups B1 and B2. CONCLUSIONS: The improvement observed in 2016 after a training programme did not prevail after 3 years. In order to keep the quality of OGDs above the recommended benchmarks, it is necessary to implement continuous training programmes.


Assuntos
Benchmarking , Duodenoscopia/normas , Esofagoscopia/normas , Gastroscopia/normas , Indicadores de Qualidade em Assistência à Saúde/normas , Biópsia/normas , Doença Celíaca/patologia , Estudos de Coortes , Duodenoscopia/educação , Duodenoscopia/estatística & dados numéricos , Esofagoscopia/educação , Esofagoscopia/estatística & dados numéricos , Hemorragia Gastrointestinal/diagnóstico por imagem , Gastroscopia/educação , Gastroscopia/estatística & dados numéricos , Humanos , Intestinos/patologia , Fotografação , Desenvolvimento de Programas , Padrões de Referência , Sociedades Médicas , Fatores de Tempo
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