To evaluate an institutional policy of EGD observation time and the detection rate of upper gastrointestinal neoplasm (UGI), all endoscopists from July 2010 to March 2019 were requested to follow institutional policy extending more than 3 minutes of observation time in every screening EGD. Observation time was defined as the time from when the endoscope reached the duodenum to when it was withdrawn and neoplasm detection rate (NDR) was obtained during this period and was compared with a baseline period from 2009 to 2015.
During the study period, 30,506 EGDs were performed. The mean subject age was 49.9 and 56.5% were men. All endoscopists achieved an average EGD observation time of more than 3 minutes during the period. Mean observation time was 3.35 and was significantly longer than the baseline at was 2.38. NDR was 33%, which was higher than the baseline (23%). Even after adjusting for subjects’ age and gender, smoking history and endoscopists’ biopsy sampling rate, prolonged EGD observation time of more than 3 minutes increased the NDR of UGI neoplasms (odds ratio 1.51).
It was concluded there was evidence that implementing a period of prolonged observation time could increase NDR and that should be an important quality indicator of the EGD examination.