Article Text
Abstract
Introduction There is increasing interest in documenting the performance of individual endoscopists for their own education and to safeguard quality standards.1 What has hitherto been lacking is an infrastructure to facilitate collection and analysis of data to allow practioners to easily compile a “report card” of their own practice or benchmark themselves against their peers.
Methods The Endoscopic Retrograde Cholangiopancreatography Quality Network (ERCP N) is a web-based tool that started as a voluntary reporting system in the US.2 Anonymised key data points (indications, sedation/anaesthesia, therapies, successes and adverse events) on each case are uploaded through a web-based interface onto a central server. 73 American endoscopists have uploaded data on 11 015 ERCP procedures. Eight British endoscopists enrolled more recently and have reported so far on 1007 procedures. Individual report cards or benchmark reports against the average of all users can be user-generated online.
Result The table shows some of the areas (mean values) where practice differed between countries. All numbers (except the total) are percentage, and all differences are statistically significant.
These data do not purport to reflect average UK and US practice, as participants are self-selected and not necessarily representative. UK endoscopists in this study performed less complex procedures as judged by the accepted complexity grade3 with lower (but acceptable) technical success rates. There were no significant differences in average procedure and fluoroscopy times or the proportion of cases involving trainees (Abstract 016).
Conclusion UK users have found it quick and easy to enter data and that it provides very useful information. Collection of this level of data about one's own practice is likely to become mandatory in the near future. We hope that these very preliminary data will encourage other UK endoscopists to participate.