title: Endoscopic quality indicators for esophagogastroduodenoscopy in gastric cancer screening.
abstract: BACKGROUND
  Quality indicators of screening esophagogastroduodenoscopy are essential to improve the detection rate of gastric cancer. However, a reliable, practical indicator of the performance of endoscopists in screening esophagogastroduodenoscopy has not yet been identified.
  
  
  OBJECTIVE
  We aimed to identify quality indicators of esophagogastroduodenoscopy for the detection of early gastric neoplasms, including gastric dysplasia and early gastric cancer, focusing on the endoscopic findings.
  
  
  METHODS
  The records of 54,889 individuals who underwent esophagogastroduodenoscopy for gastric cancer screening at the Yonsei University Severance Hospital Health Promotion Center, Seoul, Korea, between February 2006 and July 2013 were analyzed. The detection rates for various gastric lesions including early gastric neoplasms were analyzed for each endoscopist.
  
  
  RESULTS
  Gastric dysplasia, early gastric cancer, and advanced gastric cancer were detected in 97 (0.18 %), 54 (0.10 %), and 21 (0.04 %) of 54,889 individuals, respectively. Multivariate analysis showed that the detection rates of gastric subepithelial lesions and gastric diverticuli were independent factors associated with the detection rate of early gastric neoplasms (regression coefficients of 0.096 and 0.532, respectively). A quality score formula was deduced using these regression coefficients to predict the ability of an endoscopist to detect early gastric neoplasms. A trend test confirmed that the group of endoscopists with a higher quality score showed a significantly higher rate of early gastric neoplasm detection (P < 0.001).
  
  
  CONCLUSIONS
  The detection rates of gastric subepithelial lesions and gastric diverticuli are well correlated with that of early gastric neoplasms. In addition, the proposed quality scoring system could be a good quality indicator for the detection of early gastric neoplasms.
authors: Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Institute of Gastroenterology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea, chan100@yuhs.ac.
authors: Chan Hyuk
authors: CH
authors: Park
authors: Bun
authors: B
authors: Kim
authors: Hyunsoo
authors: H
authors: Chung
authors: Hyuk
authors: H
authors: Lee
authors: Jun Chul
authors: JC
authors: Park
authors: Sung Kwan
authors: SK
authors: Shin
authors: Sang Kil
authors: SK
authors: Lee
authors: Yong Chan
authors: YC
authors: Lee
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D055088:Early Detection of Cancer / Q000379:methods*; D016145:Endoscopy, Digestive System / Q000592:standards*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D015999:Multivariate Analysis; D019984:Quality Indicators, Health Care; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000453:epidemiology