Table 1.
Quality indicators for endoscopic eradication therapy using the RAND/UCLA appropriateness methodology from Wanietal. [23••]
| Quality indicator | Threshold | Process or outcome measure | |
|---|---|---|---|
| Pre-procedure | For patients in whom a diagnosis of dysplasia has been made, the rate at which the reading is made by a GI pathologist or confirmed by a second pathologist before embarking on EET. | 90% [75, 100] | Process |
| If EET is performed, then centers should have high definition white light endoscopy (HDWLE), mucosal ablation, and EMR techniques available. | N/A | Process | |
| The rate at which documentation of a discussion of the risks, benefits, and alternatives to EET is obtained from the patient prior to embarking on a course of treatment. | 99% [85, 100] | Process | |
| Intra-procedure | The rate at which landmarks and length of BE is documented (e.g., Prague grading system) in patients with Barrett’s esophagus before EET. | 90% [75, 100] | Process |
| The rate at which presence or absence of visible lesions is reported (e.g., Paris classification) in patients with Barrett’s esophagus referred for EET. | 90% [60,100] | Process | |
| The rate at which the Barrett’s esophagus segment is inspected using high definition white light endoscopy (HDWLE). | 95% [0, 100] | Process | |
| Among patients undergoing EET who have not yet achieved CE-IM, the rate at which a defined interval for subsequent EET is documented. | 90% [0, 100] | Process | |
| The rate at which CE-IM is achieved by 18 months in patients with Barrett’s-related dysplasia and intra-mucosal cancer referred for EET. | 70% [50, 80] | Outcome | |
| Post-procedure | Among patients who achieve CE-IM, the rate at which a recommendation for endoscopic surveillance at a defined interval is documented. | 90% [50,100] | Process |
| During endoscopic surveillance after EET, the rate at which biopsies of any visible mucosal abnormalities are performed. | 95% [50, 100] | Process | |
| The rate at which an anti-reflux regimen is recommended after EET. | 90% [50, 100] | Process | |
| The rate at which adverse events are being tracked and xdocumented in individuals post EET | 90% [50, 100] | Process |
EET endoscopic eradication therapy, EMR endoscopic mucosal resection, BE Barrett’s esophagus, CE-IM complete eradication of intestinal metaplasia