Compliance with Standard Protocol for the Diagnosis of Barrett’s Oesophagus: Significance of The Complete Audit Cycle | ||
| The Egyptian Journal of Hospital Medicine | ||
| Article 150, Volume 90, Issue 1, January 2023, Pages 1014-1018 PDF (485.21 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejhm.2023.280200 | ||
| Authors | ||
| Ahmed Elnabil-Mortada* ; Sherif Shabana; Sherif Albalkiny; Mohamed Elsayed Seifalyazal | ||
| department of surgery, ain shams university, cairo, egypt | ||
| Abstract | ||
| Background: The key to effective therapeutic endoscopic therapy is early dysplastic Barrett's oesophagus (BO) alteration detection. Oesophago-gastro-duodenoscopy (OGD) technical proficiency is quickly attained, but the diagnosis accuracy is still quite variable, especially in non-specialized endoscopic facilities. Objective: We aimed to evaluate the quality of endoscopic diagnosis and the adherence to guidelines of BO in our unit. Patients and Methods: A retrospective cohort analysis was done for 436 eligible endoscopic reports after independent review for confirmation of BO. Cohorts represent the complete audit cycle during the period from 01/01/2018 till 01/07/2022. Group A represented first audit data, and group B represented re-audit data. Results: A total eligible reports of 256 of BO in group A, and 180 reports in group B were reviewed. There was no significant difference between the groups regarding the age (62.7 ± 13.5 and 60.1 ± 15.1 years), male sex (68% and 70 %), and endoscopist specialty respectively. Surveillance was the most common indication (32.4% vs 35.5%), followed by Reflux (16.7% and 15%) in both groups respectively. Compliance with Prague, Paris, and Seattle protocol was significantly higher in group B (P value ≤0.05). Lack of awareness of the new guidelines, surgeon specialty, older age of the endoscopist, long segment of BO were the main factors of poor results in group A. Conclusions: In the absence of local standard protocol for endoscopic diagnosis of BO, the adherence to the guidelines was poor. Compliance with the guidelines after implementing new recommendations results in better outcomes. It is important to complete the audit cycle to ensure that the quality improvement was achieved. | ||
| Keywords | ||
| Barrett’s oesophagus; Barrett’s surveillance; Prague Criteria; Seattle protocol; Paris classification; Adherence guidelines | ||
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