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.