P0673 - The Limited Impact of EGD Intraprocedural Timing on Visualization Clarity and Clinically Significant Findings: Emphasizing Efficient Task Completion

Dharma Ayer, BS¹, Dana Gornick, MD², Sonia Samuel, DO¹, Caesar Ferrari, BS¹, Micheal Tadros, MD, MPH, FACG^1
1Albany Medical Center, Albany, NY; ²Cedars-Sinai Medical Center, Los Angeles, CA

Introduction: Esophagogastroduodenoscopy (EGD) is an important diagnostic tool for upper gastrointestinal (GI) disorders. Growing evidence suggests that Quality Indicators (QI) need to be established. Without clear QIs, there are inconsistencies in the detection of clinically significant findings (CSFs). This study aimed to assess how intraprocedural duration (time), proposed as an important QI, impacts EGD quality and CSFs.

Methods: A retrospective chart review was conducted for patients at a single center undergoing EGD during the past year (2023) for first-time diagnostic purposes. 100 randomly selected charts were reviewed. Exclusion criteria included cases of therapeutic procedures, known diagnoses (e.g. Barrett’s, varices), screening/surveillance of GI neoplasia, or PEG placements. Data collected included time (≥ or < 6 minutes), CSFs, visualization clarity, pathology, biopsies, and indications (see Table 1). Primary analysis was done to see how time impacted CSFs and visualization clarity (as assessed by the POLPREP scale using AI and a reviewer). Based on the variables, chi square or t tests were conducted.

Results: 63 patients were included in the final analysis. A total of 16 patients were found to have CSFs (25.4%). Time was not found to impact visualization clarity (p >0.05). Additionally, time was not found to impact CSFs (p >0.05). Similar findings were obtained when time was categorized to < 3, 3-6, and >6 minutes. However, specific indications exhibited distinct time profiles, with most cases falling either above or below 6 minutes. All cases of bleeding (100%) were under 6 minutes whereas 87.5% of dysphagia cases were over 6 minutes. Additionally certain indications had a higher percentage of CSFs, such as anemia (50%), bleeding (40%), and dysphagia (33%).

Discussion: Our findings suggest that intraprocedural duration is not associated with visualization clarity or CSFs. Regardless of procedure duration, adequate photo documentation and mucosal clarity were present. However, time and the percentage of CSFs seemed to vary by indication, mainly anemia, bleeding, and dysphagia. Upper endoscopies differ from colonoscopies due to the added risk of aspiration, so a longer duration of inspection may not be necessary. It is more crucial for the endoscopist to tailor the procedure based on indications, findings, and patient comorbidities, focusing on accomplishing the task rather than using time as a primary quality measure.




Disclosures:


Dharma Ayer, BS¹, Dana Gornick, MD², Sonia Samuel, DO¹, Caesar Ferrari, BS¹, Micheal Tadros, MD, MPH, FACG¹. P0673 - The Limited Impact of EGD Intraprocedural Timing on Visualization Clarity and Clinically Significant Findings: Emphasizing Efficient Task Completion, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.