Table 2

The minimal expected achievement of upper gastrointestinal endoscopy key performance indicators

Quality indicatorMinimal standardAspirational standard
A minimum number of 100 OGDs per year should be performed to maintain competenceNot applicable100%
Photo documentation should be made of relevant anatomical landmarksNot applicable>90%
Photo documentation should be made of any detected lesions>90%100%
Adequate mucosal visualisation should be achieved by a combination of both aspiration and the use of mucosal cleansing techniques75%100%
The quality of mucosal visualisation should be reportedNot Applicable90%
It is suggested that the inspection time during a diagnostic OGD should be recorded for surveillance procedures, such as Barrett’s and gastric atrophy/intestinal metaplasia surveillanceNot applicable>90%
Where a lesion is identified, this should be described using the Paris classification and targeted biopsies taken>90%100%
The length of a Barrett’s segment should be classified according to the Prague classification>90%100%
When no lesions are detected within a Barrett’s segment biopsies should be taken in accordance with the Seattle protocol>90%100%
Biopsies from two different regions in the oesophagus should be taken to rule out eosinophilic oesophagitis in those presenting with dysphagia/food bolus obstruction, where an alternative cause is not found>90%100%
Oesophageal ulcers and oesophagitis that is grade D or atypical in appearance, should be biopsied, with further evaluation in 4–6 weeks of PPI therapy>90%100%
Gastric ulcers should be biopsied and re-evaluated after appropriate treatment, including H. pylori eradication where indicated, within 6–8 weeks>90%100%
The presence of gastric polyps should be recorded, with the number, size, location and morphology described, with representative biopsies taken>90%100%
Where there are endoscopic features of gastric atrophy or intestinal metaplasia separate biopsies from the antrum and body should be takenNot applicable>90%
Where iron deficiency anaemia is being investigated, separate biopsies from the gastric antrum and body should be taken as well as duodenal specimens if coeliac serology is positive or has not been previously measuredNot applicable>90%
Where gastric or duodenal ulcers are identified, H. pylori should be tested and eradicated if positive>90%100%
Where coeliac disease is suspected, a minimum of four biopsies from the second part of the duodenum including a specimen from the duodenal bulb should be taken>90%100%
Endoscopy units should audit rates of failing to diagnose upper gastrointestinal cancer at OGD<10%<5%
  • OGD, oesophago-gastro-duodenoscopy; PPI, proton pump inhibitor.