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- W3200361733 abstract "We read with interest the article “Implementation effect of institutional policy of EGD observation time on neoplasm detection” by Park et al.1Park J.M. Kim S.Y. Shin G.Y. et al.Implementation effect of institutional policy of EGD observation time on neoplasm detection.Gastrointest Endosc. 2021; 93: 1152-1159Abstract Full Text Full Text PDF Scopus (4) Google Scholar They demonstrated that the implementation of a minimum observation time of 3 minutes from reaching the duodenum to withdrawing the endoscope resulted in a significant increase in neoplasm detection rate. This is an important study that supports the proposal of inspection time as a performance measure for upper GI endoscopy. Few studies have examined the impact of sedation on inspection time. Similarly, the use of sedation has not been proposed as part of the guidelines to improve EGD quality. Patient intolerance of the procedure could limit mucosal visualization and reduce inspection time. We performed a retrospective study of diagnostic EGDs performed at our center from January 2013 to October 2016 to compare inspection times for sedated and nonsedated patients. Adequate inspection time was defined as ≥7 minutes, as proposed by the European Society for Gastrointestinal Endoscopy.2Bisschops R. Areia M. Coron E. et al.Performance measures for upper gastrointestinal endoscopy: a European Society of Gastrointestinal Endoscopy quality improvement initiative.United European Gastroenterol J. 2016; 4: 629-656Crossref PubMed Scopus (38) Google Scholar Inspection time was calculated by the endoscopy reporting system from start time, when the endoscope is inserted into the patient’s mouth, to end time, when the endoscope is withdrawn from the patient’s mouth. Those times were inputted by an endoscopy nurse during the procedure. Included for analysis were 10,482 procedures. The median age was 57 years (interquartile range [IQR], 42–70 years), with 8191 patients (78%) receiving conscious sedation via intravenous midazolam. The median inspection time was longer for sedated patients (10 min [IQR 6–14 min]), than for nonsedated patients (8 min [IQR 5–11 min], P < .001). The inspection time in 6322 (77.2%) of sedated patients was ≥7 minutes versus 1576 (68.8%) of nonsedated patients (P < .001). Logistic regression confirmed that conscious sedation was independently associated with an inspection time ≥7 minutes (odds ratio, 1.52; 95% confidence interval, 1.37–1.69; P < .001). Our findings suggest that procedural sedation could improve EGD inspection time. Further studies are required, and future guidelines should consider including recommendations on procedural sedation. All authors disclosed no financial relationships. ResponseGastrointestinal EndoscopyVol. 94Issue 4PreviewWe thank Storan et al1 for their interest in our study.2 Full-Text PDF" @default.
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- W3200361733 date "2021-10-01" @default.
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- W3200361733 title "The effect of sedation on EGD inspection time" @default.
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- W3200361733 doi "https://doi.org/10.1016/j.gie.2021.05.013" @default.
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