Establishing a quality indicator format for endoscopic ultrasound

Table 3 Endoscopic ultrasound pre-procedural, tumor-associated, post-endoscopic ultrasound quality indicators

Quality indicators	Percent
	documented
EUS pre-procedural1
Listed indications for procedure	97%
Detailed patient description from the referring phycisian	82%
Received minimum six hour fast	8%
Given antibiotics per protocol prior to FNA of pancreatic cyst	40%
Listing of anesthesia administered prior to starting EUS	94%
Patient signed agreement of informed consent	61%
EUS findings consistent with or highly suspicious for tumor2
Description by the TNM system	5%
Tumor description (or suspected)	78%
Description of degree of tissue invasion	65%
Presence or absence of lymph nodes	46%
Reports malignant or suspicious lesions	48.50%
Post-EUS3
Summary of medical diagnoses	81.90%
Examination findings, even if not relevant to the reason for EUS referral, should be listed	37.20%
Treatment recommendations with respect to examination findings	79.80%
Advice given to patients after performing EUS	52.10%
Incidence of adverse events, including pancreatitis, bleeding, and/or infections and the need for hospitalization	0%

¹The above chart lists the percent of endoscopic ultrasound (EUS) reports in which pre-procedural quality indicators were documented. Indications and anesthesia were most frequently listed, while pre-procedural preparation, administration of antibiotics prior to fine needle aspiration of pancreatic cysts, and signing informed consent were less often listed in reports;

²This chart demonstrates the adherence to EUS quality indicators for lesions consistent with or suspected to be of malignant etiologies. Although tumors and depth of invasion were commonly described, the tumor, node, and metastasis system was seldom used;

³This table lists the physician adherence to post-procedural EUS quality indicators. Diagnoses, procedural findings relevant to reason for referral and treatment recommendations were most often documented whereas findings inconsistent with the reason for referral, post-procedural patient advice, and listing adverse events were far less often emphasized. FNA: Fine needle aspiration; TNM: Tumor, node, and metastasis.