Grading the complexity of endoscopic procedures: results of an ASGE working party

Background: Working parties of the American Society for Gastrointestinal Endoscopy (ASGE) Quality Committee recently published a proposed new lexicon for adverse events and a separate extensive review of risk factors. The complexity of procedures also affects outcomes.

Objective: To establish a system for grading the complexity of endoscopic procedures.

Design: Voting on levels 1 (easiest) to 4 (most difficult) on a list of possible procedures and contexts.

Setting: Community and academic gastroenterologists in the United States, Canada, and Britain.

Main outcome measurements: Median scores of votes cast.

Results: Consensus list of levels 1 through 4 contexts and procedures.

Limitations: Eminence rather than evidence based.

Conclusions: A consensus list was developed for comments and testing to complement the proposed lexicons for adverse events and risk factors.