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Am J Gastroenterol. 2013 Aug;108(8):1224-30. doi: 10.1038/ajg.2012.388.

Recording ERCP fluoroscopy metrics using a multinational quality network: establishing benchmarks and examining time-related improvements.

Author information

1
Division of Gastroenterology and Hepatology, Medical University of South Carolina, Charleston, SC 29425, USA. romagnuo@musc.edu

Abstract

OBJECTIVES:

We aimed to establish benchmarks for fluoroscopy time (FT) in endoscopic retrograde cholangiopancreatography (ERCP) and assess the effect of physician practice networking on time trends.

METHODS:

Data from the ERCP Quality Network were used to assess practice variability in FT and establish case- and provider-level benchmarks of the first 200 cases for providers entering more than 100 cases. Trends in FT and high FT, by 50-patient groupings, were assessed by multilevel multivariate linear and logistic regression models.

RESULTS:

Median FT was 2.9 minutes, averaging 16% of procedure time. Ninetieth percentiles for the 57 eligible providers were 10 minutes and 22% (n = 9, 185 ERCP). Every 50 cases entered was associated with lower FT. In multivariate analysis, more cases entered, higher lifetime and annual volumes, lower difficulty grade, and manometry had lower FTs; academics, trainee involvement, various therapeutics, and failed cannulation had higher FTs.

CONCLUSIONS:

FT is highly variable, and many provider and case factors predict FT. FT benchmarks are now available. Self-review of one's case FT might decrease FT.

Comment in

PMID:
23912400
DOI:
10.1038/ajg.2012.388
[Indexed for MEDLINE]

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