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Impact Of Trainee Involvement On The Endoscopist Biopsy Rate And Detection Of Premalignant Conditions At Upper Gastrointestinal Endoscopy

Monica State, Andrei Voiosu, A. Bengus, Theodor Voiosu, Bogdan Mateescu

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Abstract

Aims Validated quality indicators for upper-GI endoscopy are essential in order to provide optimal patient care. Recently, the endoscopist biopsy rate (EBR) has been shown to correlate with increased detection of upper GI premalignant conditions (UPC) [[ 1 ]]. We aimed to determine if the EBR rate of the senior endoscopists varied according to trainee involvement in the procedures. Methods We conducted a retrospective analysis of EGDs performed by senior and trainee endoscopists in a teaching hospital from Romania. EBR was defined as the proportion of EGDs with ≥1 biopsy to all examinations. UPC included histopathology results of intestinal metaplasia, gastric mucosal atrophy, dysplasia, adenoma. EBR and UPC detection rate among seniors and trainee vs. senior endoscopists were calculated. Impact of patient-related factors (age, gender, indication for EGD) on EBR was assessed using a linear regression model. Results One thousand one hundred and eighteen procedures performed by 10 attendants (469) and supervised trainees (649) were analysed. The EBR did not differ according to trainee involvement (37.8 % vs. 37.6 %, p =0.52 χ 2 ) but was very variable among seniors (23 - 64 %, p <0.005 χ 2 ). Overall the UPC detection rate was 34.6 %, with no significant difference between the trainees and seniors ( p =0.96, χ 2 ) after exclusion of patients with known neoplasia or premalignant lesions. 198 (51.8 %) of the biopsies were negative and on multivariate analysis, gender, age above 65 and indication of procedure did not influence the UPC detection rate. Conclusions Trainee involvement in EGD doesn’t influence the biopsy and UPC detection rates. The EBR within our unit is high and might reflect variable adherence to guidelines. Citation: State M, Voiosu A, Bengus A et al. OP199 IMPACT OF TRAINEE INVOLVEMENT ON THE ENDOSCOPIST BIOPSY RATE AND DETECTION OF PREMALIGNANT CONDITIONS AT UPPER GASTROINTESTINAL ENDOSCOPY. Endoscopy 2021; 53: S82. Publication History Publication Date: 19 March 2021 (online) © 2021. European Society of Gastrointestinal Endoscopy. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

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Aims Validated quality indicators for upper-GI endoscopy are essential in order to provide optimal patient care. Recently, the endoscopist biopsy rate (EBR) has been shown to correlate with increased detection of upper GI premalignant conditions (UPC) [[ 1 ]]. We aimed to determine if the EBR rate of the senior endoscopists varied according to trainee involvement in the procedures. Methods We conducted a retrospective analysis of EGDs performed by senior and trainee endoscopists in a teaching hospital from Romania. EBR was defined as the proportion of EGDs with ≥1 biopsy to all examinations. UPC included histopathology results of intestinal metaplasia, gastric mucosal atrophy, dysplasia, adenoma. EBR and UPC detection rate among seniors and trainee vs. senior endoscopists were calculated. Impact of patient-related factors (age, gender, indication for EGD) on EBR was assessed using a linear regression model. Results One thousand one hundred and eighteen procedures performed by 10 attendants (469) and supervised trainees (649) were analysed. The EBR did not differ according to trainee involvement (37.8 % vs. 37.6 %, p =0.52 χ 2 ) but was very variable among seniors (23 - 64 %, p <0.005 χ 2 ). Overall the UPC detection rate was 34.6 %, with no significant difference between the trainees and seniors ( p =0.96, χ 2 ) after exclusion of patients with known neoplasia or premalignant lesions. 198 (51.8 %) of the biopsies were negative and on multivariate analysis, gender, age above 65 and indication of procedure did not influence the UPC detection rate. Conclusions Trainee involvement in EGD doesn’t influence the biopsy and UPC detection rates. The EBR within our unit is high and might reflect variable adherence to guidelines. Citation: State M, Voiosu A, Bengus A et al. OP199 IMPACT OF TRAINEE INVOLVEMENT ON THE ENDOSCOPIST BIOPSY RATE AND DETECTION OF PREMALIGNANT CONDITIONS AT UPPER GASTROINTESTINAL ENDOSCOPY. Endoscopy 2021; 53: S82. Publication History Publication Date: 19 March 2021 (online) © 2021. European Society of Gastrointestinal Endoscopy. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

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Available abstract

Aims Validated quality indicators for upper-GI endoscopy are essential in order to provide optimal patient care. Recently, the endoscopist biopsy rate (EBR) has been shown to correlate with increased detection of upper GI premalignant conditions (UPC) [[ 1 ]]. We aimed to determine if the EBR rate of the senior endoscopists varied according to trainee involvement in the procedures. Methods We conducted a retrospective analysis of EGDs performed by senior and trainee endoscopists in a teaching hospital from Romania. EBR was defined as the proportion of EGDs with ≥1 biopsy to all examinations. UPC included histopathology results of intestinal metaplasia, gastric mucosal atrophy, dysplasia, adenoma. EBR and UPC detection rate among seniors and trainee vs. senior endoscopists were calculated. Impact of patient-related factors (age, gender, indication for EGD) on EBR was assessed using a linear regression model. Results One thousand one hundred and eighteen procedures performed by 10 attendants (469) and supervised trainees (649) were analysed. The EBR did not differ according to trainee involvement (37.8 % vs. 37.6 %, p =0.52 χ 2 ) but was very variable among seniors (23 - 64 %, p <0.005 χ 2 ). Overall the UPC detection rate was 34.6 %, with no significant difference between the trainees and seniors ( p =0.96, χ 2 ) after exclusion of patients with known neoplasia or premalignant lesions. 198 (51.8 %) of the biopsies were negative and on multivariate analysis, gender, age above 65 and indication of procedure did not influence the UPC detection rate. Conclusions Trainee involvement in EGD doesn’t influence the biopsy and UPC detection rates. The EBR within our unit is high and might reflect variable adherence to guidelines. Citation: State M, Voiosu A, Bengus A et al. OP199 IMPACT OF TRAINEE INVOLVEMENT ON THE ENDOSCOPIST BIOPSY RATE AND DETECTION OF PREMALIGNANT CONDITIONS AT UPPER GASTROINTESTINAL ENDOSCOPY. Endoscopy 2021; 53: S82. Publication History Publication Date: 19 March 2021 (online) © 2021. European Society of Gastrointestinal Endoscopy. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

Key concepts: Medicine, Endoscopy, Biopsy, Upper gastrointestinal endoscopy, Upper endoscopy, Gastroenterology, Surgery, Internal medicine

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