Umbrella systematic review of potential quality indicators for the detection of dysplasia and cancer at upper gastrointestinal endoscopy - Abstract and key findings

Sep 24, 2026

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Umbrella systematic review evaluates potential quality indicators that may improve detection of upper gastrointestinal (UGI) cancer and dysplasia during upper GI endoscopy, a setting lacking established quality metrics. Searches covered systematic reviews and primary diagnostic accuracy or detection-rate studies up to December 2021, with AMSTAR2 and JBI tools used for appraisal. Clinical heterogeneity prevented meta-analysis, and results were synthesized narratively.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages14

Reading Time35 min

AccessFree to download

Abstract

Background and study aims

Methods

Results

Conclusions

Introduction

Umbrella systematic review of potential quality indicators for the detection of dysplasia and cancer at upper gastrointestinal endoscopy Authors Umair Kamran1, Abdullah Abbasi2, Nosheen Umar1, Imran Tahir3, Matthew J Brookes4,5, Matt Rutter6,7, Mimi McCord8, Nicola J Adderley9, Janine Dretzke10, Nigel Trudgill1,11 Institutions 1 Gastroenterology, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, United Kingdom of Great Britain and Northern Ireland 2 Gastroenterology, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, United Kingdom of Great Britain and Northern Ireland 3 Gastroenterology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom of Great Britain and Northern Ireland 4 Department of Gastroenterology, Royal Wolverhampton NHS Trust, Wolverhampton, United Kingdom of Great Britain and Northern Ireland 5 Research Institute in Healthcare Science, University of Wolverhampton, Wolverhampton, United Kingdom of Great Britain and Northern Ireland 6 Gastroenterology, University Hospital of North Tees, Stockton on Tees, United Kingdom of Great Britain and Northern Ireland 7 Population Health Sciences Institute, Newcastle University Faculty of Medical Sciences, Newcastle upon Tyne, United Kingdom of Great Britain and Northern Ireland 8 n/a, Heartburn Cancer, Hampshire, United Kingdom of Great Britain and Northern Ireland 9 Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom of Great Britain and Northern Ireland 10 University of Birmingham , University of Birmingham, Birmingham, United Kingdom of Great Britain and Northern Ireland 11 Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom of Great Britain and Northern Ireland Key words Endoscopy Upper GI Tract, Barrett's and adenocarcinoma, Precancerous conditions & cancerous lesions (displasia and cancer) stomach, Diagnosis and imaging (inc chromoendoscopy, NBI, iSCAN, FICE, CLE) received 14.9.2022 accepted after revision 13.6.2023 Bibliography Endosc Int Open 2023; 11: E835–E848 DOI 10.1055/a-2117-8621 ISSN 2364-3722 © 2023. The Author(s) . This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ([https://creativecommons.org/licenses/by-nc-nd/4.0/](https://creativecommons.org/licenses/by-nc-nd/4.0/)) Georg Thieme Verlag KG, Rüdigerstraße 14, 70469 Stuttgart, Germany Corresponding author Nicola J Adderley, University of Birmingham, Institute of Applied Health Research, Birmingham, United Kingdom of Great Britain and Northern Ireland [n.j.adderley@bham.ac.uk](n.j.adderley@bham.ac.uk) Additional material is available at [https://doi.org/10.1055/a-2117-8621](https://doi.org/10.1055/a-2117-8621) ABSTRACT Background and study aims Upper gastrointestinal (UGI) endoscopy lacks established quality indicators. We conducted an umbrella systematic review of potential quality indicators for the detection of UGI cancer and dysplasia. Methods Bibliographic databases were searched up to December 2021 for systematic reviews and primary studies. Studies reporting diagnostic accuracy, detection rates orthe association of endoscopy or endoscopist-related factors with UGI cancer or dysplasia detection were included. AMSTAR2 and JBI checklists were used to assess systematic review and primary study quality. Clinical heterogeneity precluded meta-analysis and findings are summarized narratively. Kamran Umair et al. Umbrella systematic review… Endosc Int Open 2023; 11: E835–E848 | © 2023. The Author(s) . E835 Results Eight systematic reviews and nine primary studies were included. Image enhancement, especially narrow band imaging, had h

FAQs

What problem does the umbrella systematic review address?

Upper gastrointestinal endoscopy lacks established quality indicators for detecting cancer and dysplasia. The review identifies potential indicators that could improve detection.

How were studies identified and quality assessed?

Bibliographic databases were searched up to December 2021 for systematic reviews and primary studies. AMSTAR2 was used for systematic reviews and JBI checklists for primary studies.

What key indicators showed higher diagnostic performance or detection?

Image enhancement, especially narrow band imaging, showed high diagnostic accuracy. Longer examination times, higher endoscopist biopsy rates, and propofol sedation were associated with increased detection in included studies.

Sep 24, 2026

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