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News

Recording ERCP fluoroscopy metrics using a multinational quality network

A study in the most recent issue of the American Journal of Gastroenterology examined time-related improvements of endoscopic retrograde cholangiopancreatography fluoroscopy metrics using a multinational quality network.

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The researchers established benchmarks for fluoroscopy time in endoscopic retrograde cholangiopancreatography, and assessed the effect of physician practice networking on time trends.

Dr Joseph Romagnuolo from South Carolina, USA and colleagues analyzed data from the Endoscopic Retrograde Cholangiopancreatography Quality Network.

The team assessed practice variability in fluoroscopy time, and established case- and provider-level benchmarks of the first 200 cases for providers entering more than 100 cases.

Trends in fluoroscopy time and high fluoroscopy time, by 50-patient groupings were assessed by multilevel multivariate linear and logistic regression models.

Median fluoroscopy time was about 3 minutes
American Journal of Gastroenterology

Median fluoroscopy time was about 3 minutes, averaging 16% of procedure time.

The research team found that the 90th percentiles for the 57 eligible providers were 10 minutes and 22%.

Every 50 cases entered was associated with lower fluoroscopy time.

In multivariate analysis, more cases entered, higher lifetime and annual volumes, lower difficulty grade, and manometry had lower fluoroscopy times; academics, trainee involvement, various therapeutics, and failed cannulation had higher fluoroscopy times.

Dr Romagnuolo's team concludes, "Fluoroscopy time is highly variable, and many provider and case factors predict fluoroscopy time."

"Fluoroscopy time benchmarks are now available."

"Self-review of one’s case fluoroscopy time might decrease fluoroscopy time."

Am J Gastroenterol 2013: 108: 1224–1230
19 August 2013

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