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Review
. 2025 Apr;57(4):366-389.
doi: 10.1055/a-2522-1995. Epub 2025 Feb 5.

Performance measures for small-bowel endoscopy: a European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative - Update 2025

Reena Sidhu  1   2 , Mohamed G Shiha  1   2 , Cristina Carretero  3 , Anastasios Koulaouzidis  4   5   6 , Xavier Dray  7 , Alessandro Mussetto  8 , Martin Keuchel  9 , Cristiano Spada  10   11 , Edward J Despott  12 , Stefania Chetcuti Zammit  13 , Deirdre McNamara  14 , Emanuele Rondonotti  15 , João Sabino  16 , Monika Ferlitsch  17   18 ; External Voting Panel
Collaborators, Affiliations
Free article
Review

Performance measures for small-bowel endoscopy: a European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative - Update 2025

Reena Sidhu et al. Endoscopy. 2025 Apr.
Free article

Abstract
in English, German

Quality markers and patient experience are being implemented to ensure standardization of practice across gastrointestinal (GI) endoscopy procedures. The set benchmarks ensure high quality procedures are delivered and linked to measurable outcomes.There has been an increase in the demand for small-bowel endoscopy. In 2019, the European Society of Gastrointestinal Endoscopy (ESGE) embarked on setting performance measures for small-bowel endoscopy. This included major (key) and minor performance indicators for both small-bowel capsule endoscopy (SBCE) and device-assisted enteroscopy (DAE). These suggested quality indicators cover all procedure domains, from patient selection and preparation, to intraprocedural aspects such as pathology identification, appropriate management, the patient experience, and post-procedure complications. Since 2019, there has been an increase in published studies looking at different aspects of small-bowel endoscopy, including real-world data. This paper provides an update on the 2019 performance measures, considering the latest literature.

Quality markers and patient experience are being implemented to ensure standardization of practice across gastrointestinal (GI) endoscopy procedures. The set benchmarks ensure high quality procedures are delivered and linked to measurable outcomes.There has been an increase in the demand for small-bowel endoscopy. In 2019, the European Society of Gastrointestinal Endoscopy (ESGE) embarked on setting performance measures for small-bowel endoscopy. This included major (key) and minor performance indicators for both small-bowel capsule endoscopy (SBCE) and device-assisted enteroscopy (DAE). These suggested quality indicators cover all procedure domains, from patient selection and preparation, to intraprocedural aspects such as pathology identification, appropriate management, the patient experience, and post-procedure complications. Since 2019, there has been an increase in published studies looking at different aspects of small-bowel endoscopy, including real-world data. This paper provides an update on the 2019 performance measures, considering the latest literature.

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Conflict of interest statement

E.J. Despott has received educational grants, plus speaker’s and consultancy fees from Fujifilm (2017 to present), educational grants and consultancy fees from Boston Scientific (2017 to present), educational grants from Olympus Medical (2017 to present) and Pentax Medical (2017–2019), consultancy fees from Ambu (2017–2018), and educational grants and speaker’s fees from Norgine (2017 to present). X. Dray is a co-founder and shareholder in Augmented Endoscopy (2019 to present) and was the inaugural (and now past) president of the international CApsule endoscopy Research (iCARE) group (2021 to present); his department has received support for lectures and continuing medical education from Medtronic (2023); and the following patents are held: Automatic quality classification of wireless capsule endoscopy images from small bowel according a computer-based score (EP18305275.2. 2019); Methods and devices for calculating a level of “clinical relevance” for abnormal small bowel findings captured by capsule endoscopy video (US20220039639A1. 2022); Device and method for producing a numerical classifier of images, so as to determine the viewing quality of the endoscopic videocapsule images of a segment of the digestive tube. (WO2019175248A1. 2019); Device and method for producing a digital video classifier (US 2022/0101525 A1). M. Ferlitsch has received speaker’s fees from Ferring, Olympus, and Norgine. M. Keuchel has received speaker’s fees from Medtronic (2002 to present), speaker’s fees and study support from Jinshan (2023 to present), study support from AnX Robotics (2019 to present) and Norgine (2020–2023), and is a consultant for Medtronic (2002 to present) and CapsoVision (2023 to present); he is also a co-editor of the Springer book Video Capsule Endoscopy. A. Koulaouzidis has provided consultancy to Jinshan Group Ltd. (2021 to present), he is a co-founder and stakeholder in AJM Medicaps Ltd. (2017 to present) and a stakeholder in iCERV Ltd. (2021 to present); the following patent is held: Intestinal diagnostic screening device and method for targeted gastrointestinal therapy (WO2021038464A1). D. McNamara has received speaker’s fee and meeting sponsorship from Medtronic (2022, 2023), and sponsored access to a cloud reading platform (2021 to present). E. Rondonotti has received speaker’s fees from Fujifilm (2020 to present) and has provided consultancy to Medtronic Co. (2022 to present). J. Sabino has received speaker’s fees from Pfizer, Abbvie, Ferring, Falk, Takeda, Janssen, Fresenius, and Galapagos; consultancy fees from Pfizer, Janssen, Ferring, Fresenius, Abbvie, Galapagos, Celltrion, Pharmacosmos, and Pharmanovia; and research support from Galapagos and Viatris; he is supported by a research grant from the Research Foundation – Flanders. C. Spada has received speaker’s fees and travel support from AnX Robotics and Medtronic (2020 to present); speaker’s fees from Olympus, Boston Scientific, Pentax, and Norgine (2020 to present). C. Carretero, A. Mussetto, M.G. Shiha, R. Sidhu, and S.C. Zammit declare that they have no conflict of interest. External Voting Panel: M. McAlindon received support for capsule endoscopy research studies from Ankon Ltd (2022 to 2024). A. Murino received speaker’s fees from Fujifilm, Laborie, and Hikma (2023). M. Pennazio received consultancy fees from Medtronic (2005 to 2022). J. Plevris received consultancy fees from Jinshan (2019 to present). L. Elli, B. Rosa, and D. Sanders declare that they have no conflict of interest.

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