title: Examination time as a quality indicator of screening upper gastrointestinal endoscopy for asymptomatic examinees.
abstract: OBJECTIVE
  The significance of examination time of esophagogastroduodenoscopy (EGD) for asymptomatic examinees is yet to be established. We aimed to clarify whether endoscopists who allot more examination time can detect higher numbers of neoplastic lesions among asymptomatic examinees.
  
  
  METHODS
  We reviewed a database of consecutive examinees who underwent EGD in our hospital from April 2010 to September 2015. Staff endoscopists were classified into fast, moderate, and slow groups based on the mean examination time of EGD without a biopsy. Neoplastic lesion detection rate among these groups was compared using multiple logistic regression.
  
  
  RESULTS
  Of the 55 786 consecutive examinees who underwent EGD, 15 763 asymptomatic examinees who were screened by staff doctors were analyzed. Mean examination time of 13 661 EGD without biopsy was 6.2 min (range, 2-18 min). When cut-off times of 5 and 7 min were used, four endoscopists were classified into the fast (mean duration, 4.4 ± 1.0 min), 12 into the moderate (6.1 ± 1.4 min), and four into the slow (7.8 ± 1.9 min) groups. Neoplastic lesion detection rates in the fast, moderate, and slow groups were 0.57% (13/2288), 0.97% (99/10 180), and 0.94% (31/3295), respectively. Compared with that in the fast group, odds ratios for the neoplastic lesion detection rate in the moderate and slow groups were 1.90 (95% confidence interval [CI], 1.06-3.40) and 1.89 (95% CI, 0.98-3.64), respectively.
  
  
  CONCLUSIONS
  Endoscopists who do not allot adequate examination time may overlook neoplastic lesions in the upper gastrointestinal tract.
authors.affiliation: Department of Gastroenterology, Kyoto Second Red Cross Hospital, Kyoto, Japan.
authors.forename: Takuji
authors.initials: T
authors.lastname: Kawamura
authors.affiliation: Department of Gastroenterology, Kyoto Second Red Cross Hospital, Kyoto, Japan.
authors.forename: Hironori
authors.initials: H
authors.lastname: Wada
authors.affiliation: Department of Gastroenterology, Kyoto Second Red Cross Hospital, Kyoto, Japan.
authors.forename: Naokuni
authors.initials: N
authors.lastname: Sakiyama
authors.affiliation: Department of Gastroenterology, Kyoto Second Red Cross Hospital, Kyoto, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Ueda
authors.affiliation: Department of Gastroenterology, Kyoto Second Red Cross Hospital, Kyoto, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Shirakawa
authors.affiliation: Department of Gastroenterology, Kyoto Second Red Cross Hospital, Kyoto, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Okada
authors.affiliation: Department of Gastroenterology, Kyoto Second Red Cross Hospital, Kyoto, Japan.
authors.forename: Kasumi
authors.initials: K
authors.lastname: Sanada
authors.affiliation: Department of Gastroenterology, Kyoto Second Red Cross Hospital, Kyoto, Japan.
authors.forename: Kojiro
authors.initials: K
authors.lastname: Nakase
authors.affiliation: Department of Gastroenterology, Kyoto Second Red Cross Hospital, Kyoto, Japan.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Mandai
authors.affiliation: Department of Gastroenterology, Kyoto Second Red Cross Hospital, Kyoto, Japan.
authors.forename: Azumi
authors.initials: A
authors.lastname: Suzuki
authors.affiliation: Department of Health Care, Kyoto Second Red Cross Hospital, Kyoto, Japan.
authors.forename: Mai
authors.initials: M
authors.lastname: Kamaguchi
authors.affiliation: Department of Gastroenterology, Kyoto Second Red Cross Hospital, Kyoto, Japan.
authors.forename: Atsuhiro
authors.initials: A
authors.lastname: Morita
authors.affiliation: Department of Health Care, Kyoto Second Red Cross Hospital, Kyoto, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Nishioji
authors.affiliation: Department of Gastroenterology, Kyoto Second Red Cross Hospital, Kyoto, Japan.
authors.forename: Kiyohito
authors.initials: K
authors.lastname: Tanaka
authors.affiliation: Department of Health Care, Kyoto Second Red Cross Hospital, Kyoto, Japan.
authors.forename: Naomi
authors.initials: N
authors.lastname: Mochizuki
authors.affiliation: Department of Gastroenterology, Kyoto Second Red Cross Hospital, Kyoto, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Uno
authors.affiliation: Department of Biostatistics, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Isao
authors.initials: I
authors.lastname: Yokota
authors.affiliation: Department of Health Care, Kyoto Second Red Cross Hospital, Kyoto, Japan.
authors.forename: Masao
authors.initials: M
authors.lastname: Kobayashi
authors.affiliation: Department of Gastroenterology, Kyoto Second Red Cross Hospital, Kyoto, Japan.
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Yasuda
mesh_terms: D000368:Aged; D058070:Asymptomatic Diseases; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010808:Physical Examination; D019984:Quality Indicators, Health Care; D012189:Retrospective Studies; D013997:Time Factors; D041742:Upper Gastrointestinal Tract
keywords: cancer screening; endoscopy; esophageal cancer; gastric cancer; quality indicator