Key performance measure	Indication for DAE
Description	Percentage of DAEs performed for an appropriate indication
Domain	Pre-procedure
Category	Process
Rationale	Adherence to appropriate indications for DAE (in accordance with ESGE guidance) ensures patient safety (by a reduction of risk associated with unnecessary procedures), may improve diagnostic and therapeutic yield, and enhances efficiency relating to appropriate allocation of limited resources
Construct	Denominator: DAE procedures performed Numerator: Proportion of DAE procedures performed for an appropriate indication: therapy in patients with positive findings at capsule endoscopy; patients with obscure GI bleeding when SBCE is not available or is contraindicated; in selected cases of ongoing overt obscure GI bleeding; patients with ongoing obscure GI bleeding and an unremarkable capsule endoscopy; for biopsy in patients with noncontributory ileocolonoscopy and with suspicion of Crohn disease on radiologic imaging tests or capsule endoscopy; in Crohn disease patients, when endotherapy is indicated; when an imaging test shows suspicion of small-bowel tumor; for biopsy in patients in whom there is an uncertain diagnosis of small-bowel tumor at capsule endoscopy; when a submucosal mass is detected by capsule endoscopy; in patients with inherited polyposis syndromes when polypectomy is indicated; in patients with nonresponsive or refractory celiac disease for biopsy Exclusions: None Calculation: Proportion (%) Level of analysis: Service level Frequency: Yearly and/or for a sample of 50 DAEs
Standards	Minimum standard: ≥95% Target standard: ≥95% Regular audit should be encouraged to assess whether procedures are being performed for recognized indications After evaluation and adjustment, close monitoring should be performed with a further audit within 12 months
Consensus agreement	100%
PICO number	1 (see Supporting information, DAE file)
Evidence grading	Moderate-quality evidence