Adherence of Greek gastroenterologists to established quality indicators in gastrointestinal endoscopy

Georgios Axiaris; Alexandros Ioannou; Konstantina Dimopoulou; Stavros P. Papadakos; Panagiotis Baxevanis; Margarita Papatheodoridi; Xenofon Tsamakidis; Georgios Tziatzios; Ioannis S. Papanikolaou; Konstantinos Triantafyllou; Spyridon Michopoulos; Kalliopi Panagiotopoulou; Konstantina D. Paraskeva

Authors Georgios Axiaris, Alexandros Ioannou, Konstantina Dimopoulou, Stavros P. Papadakos, Panagiotis Baxevanis, Margarita Papatheodoridi, Xenofon Tsamakidis, Georgios Tziatzios, Ioannis S. Papanikolaou, Konstantinos Triantafyllou, Spyridon Michopoulos, Kalliopi Panagiotopoulou, Konstantina D. Paraskeva.

Abstract

Background Quality assessment is a priority in gastroenterology. Data on adherence to endoscopy quality standards in Greece remain limited. This study examined Greek gastroenterologists’ compliance with endoscopic quality indicators.

Methods This survey collected data on the quality of upper and lower gastrointestinal endoscopy in Greece. Hellenic Society of Gastroenterology members were invited to complete an electronic survey that included validated endoscopic quality indicators.

Results In total, 164 gastroenterologists participated, of whom 107 (65%) were male. Gastroscopy duration was not recorded by 116 (71%), whereas 102 (62%) used photodocumentation. Use of Prague and Los Angeles classifications was high (156/95% and 159/97%). Complications were recorded by 103 (63.58%) after gastroscopy and 90 (55.56%) after colonoscopy. In colonoscopy, 140 (90.85%) used the Boston Bowel Preparation Scale and 158 (96.34%) achieved cecal intubation. An adenoma detection rate >25% was achieved by 117 (71.78%), and 103 (62.8%) used the Paris classification. Overall compliance with upper and lower endoscopy quality indicators was 87 (53%) and 75 (46%), respectively. Multivariate analysis showed that experience (odds ratio [OR] 2.25, 95% confidence interval [CI] 1-5.06; P=0.049), video recording (OR 2.55, 95%CI 1.23-5.28; P=0.012), and high-resolution endoscope use (OR 2.92, 95%CI 1.39-6.09; P=0.004) were associated with better compliance during upper endoscopy. For lower endoscopy significant predictors included video recording (OR 2.20, 95%CI 1.11-4.33; P=0.023), age (OR 4.33, 95%CI 1.67-11.24; P=0.003) and high-resolution endoscope use (OR 2.67, 95%CI 1.34-5.3; P=0.005).

Conclusion In this survey, discrepancies were observed in Greek endoscopists’ compliance with endoscopic quality indicators, underscoring the need for further improvement.

Keywords Quality indicators, gastroscopy, colonoscopy, endoscopy

Ann Gastroenterol 2026; 39 (5): 571-580