Quality of Endoscopy Reports for Esophageal Cancer Patients: Where Do We Stand?

J Gastrointest Surg. 2018 May;22(5):778-784. doi: 10.1007/s11605-018-3710-4. Epub 2018 Mar 5.

Abstract

Backgrounds and aims: As treatment for esophageal cancer often involves a multidisciplinary approach, the initial endoscopic report is essential for communication between providers. Several guidelines have been established to standardize endoscopic reporting. This study evaluates the compliance of esophagogastroduodenoscopy (EGD) and endoscopic ultrasound (EUS) reporting with the current national guidelines.

Methods: Combining the National Comprehensive Cancer Network and Society of Thoracic Surgeons guidelines, 11 quality indicators (QIs) for EGD and 8 for EUS were identified. We evaluated initial EGD and EUS reports from our institution (Memorial Sloan Kettering [MSK]) and outside hospitals (OSHs) and calculated individual and overall quality measure scores. Scores between locations were compared using the Wilcoxon signed-rank test and McNemar's test for paired data.

Results: In total, 115 initial EGD reports and 105 EUS reports were reviewed for patients who underwent surgery for esophageal cancer between 2014 and 2016. The median number of QIs reported for the initial EGD was 4 (IQR, 3-6)-only 34% of reports qualified as "good quality" (those with ≥ 6 QIs). None of the reports included all QIs. For patients who underwent EGD at both MSK and an OSH, 32% of reports from OSHs were good quality, compared with 68% from MSK (p < 0.001). Compliance with QIs was better for EUS reports: 71% of OSH reports and 72% of MSK reports were good quality.

Conclusions: Detailed information on the initial endoscopic assessment is essential in today's age of multidisciplinary care. Identification and adoption of QIs for endoscopic reporting is warranted to ensure the provision of appropriate treatment.

Keywords: Endoscopic ultrasound; Esophageal cancer; Esophagogastric endoscopy; Quality indicators; Standardization.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Documentation / standards*
  • Endoscopy, Gastrointestinal*
  • Endosonography*
  • Esophageal Neoplasms / diagnostic imaging*
  • Esophageal Neoplasms / surgery
  • Female
  • Guideline Adherence / statistics & numerical data*
  • Humans
  • Male
  • Medical Records / standards*
  • Middle Aged
  • Practice Guidelines as Topic
  • Quality Indicators, Health Care