High-vs. low-volume endoscopy centers: Does it make a difference for ERCP?

In a new study, published in Clinical Gastroenterology and Hepatology, researchers examine the variation in clinical outcomes between high-and low-volume endoscopists and endoscopy centers.

 

The study authors examined studies from Medline, Embase and the Cochrane Central Register of Controlled Trials from inception to January 2018 that included outcomes by volume. Among the 13 articles included in the review, researchers found high-volume endoscopists were more likely to achieve success with endoscopic retrograde cholangiopancreatography than the low-volume endoscopists and centers.

The studies varied in the definition of "low volume"; among endoscopists, low volume was defined as fewer than 25 ERCPs to fewer than 156 ERCPs per year while low-volume centers were described as facilities with fewer than 87 ERCPs to fewer than 200 ERCPs per year.

The adverse event risk was lower among high-volume endoscopists, but there was no difference between high-and low-volume centers.

"Given these compelling findings, we propose that providers and payers consider consolidating ERCP to [high-volume] endoscopists to improve ERCP outcome and value," concluded the study authors.

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