American Society for Gastrointestinal Endoscopy
Full Text Guideline
Evidence Supporting the Recommendations
The type of evidence supporting the recommendations is not specifically stated.
Implementation of the Guideline
An implementation strategy was not provided.
Benefits/Harms of Implementing the Guideline Recommendations
Appropriate understanding of adverse events associated with endoscopic ultrasound (EUS) and EUS with fine-needle aspiration (FNA) may help to reduce the risk of future adverse events and improve the overall quality of endoscopy.
Rating Scheme for the Strength of the Recommendations
- This document is based on a critical review of the available data and expert consensus at the time that the document was drafted. Further controlled clinical studies may be needed to clarify aspects of this document. This document may be revised as necessary to account for changes in technology, new data, or other aspects of clinical practice.
- This document is intended to be an educational device to provide information that may assist endoscopists in providing care to patients. This document is not a rule and should not be construed as establishing a legal standard of care or as encouraging, advocating, requiring, or discouraging any particular treatment. Clinical decisions in any particular case involve a complex analysis of the patient's condition and available courses of action. Therefore, clinical considerations may lead an endoscopist to take a course of action that varies from this document.
Hand-searches of Published Literature (Primary Sources)
Hand-searches of Published Literature (Secondary Sources)
Searches of Electronic Databases
A search of the medical literature was performed by using PubMed. Additional references were obtained from the bibliographies of the identified articles and from recommendations of expert consultants. When few or no data exist from well-designed prospective trials, emphasis is given to results of large series and reports from recognized experts.
The time frame for all searches was January 1990 to January 2013.
Review of Published Meta-Analyses
This document is based on a critical review of the available data and expert consensus at the time that the document was drafted.
A formal cost analysis was not performed and published cost analyses were not reviewed.
Internal Peer Review
This document was reviewed and approved by the Governing Board of the American Society for Gastrointestinal Endoscopy.
Identifying Information and Availability
ASGE Standards of Practice Committee, Early DS, Acosta RD, Chandrasekhara V, Chathadi KV, Decker GA, Evans JA, Fanelli RD, Fisher DA, Fonkalsrud L, Hwang JH, Jue TL, Khashab MA, Lightdale JR, Muthusamy VR, Pasha SF, Saltzman JR, Sharaf RN, Shergill AK, Cash BD. Adverse events associated with EUS and EUS with FNA. Gastrointest Endosc. 2013 Jun;77(6):839-43. [63 references] PubMed
Not applicable: The guideline was not adapted from another source.
American Society for Gastrointestinal Endoscopy
Standards of Practice Committee
Committee Members: Dayna S. Early, MD; Ruben D. Acosta, MD; Vinay Chandrasekhara, MD; Krishnavel V. Chathadi, MD; G. Anton Decker, MD; John A. Evans, MD; Robert D. Fanelli, MD, SAGES Representative; Deborah A. Fisher, MD; Lisa Fonkalsrud, RN, SGNA Representative; Joo Ha Hwang, MD; Terry L. Jue, MD; Mouen A. Khashab, MD; Jenifer R. Lightdale, MD; V. Raman Muthusamy, MD; Shabana F. Pasha, MD; John R. Saltzman, MD; Ravi N. Sharaf, MD; Amandep K. Shergill, MD; Brooks D. Cash, MD (Chair)
The following authors disclosed a financial relationship relevant to this publication: Dr Fisher, consultant to Epigenomics, Inc; Dr Hwang, consultant to U.S. Endoscopy and speaker for Novartis; Dr Pasha, research support from Capervision. The other authors disclosed no financial relationships relevant to this publication.
This is the current release of the guideline.
Electronic copies: Available from the American Society for Gastrointestinal Endoscopy Web site.
Print copies: Available from the American Society for Gastrointestinal Endoscopy, 1520 Kensington Road, Suite 202, Oak Brook, IL 60523
This NGC summary was completed by ECRI Institute on September 25, 2013.
This NGC summary is based on the original guideline, which is subject to the guideline developer's copyright restrictions.
Diseases and conditions requiring endoscopic ultrasound (EUS) and EUS with fine-needle aspiration (FNA)
Advanced Practice Nurses
To provide information that may assist endoscopists in providing care to patients undergoing endoscopic ultrasound (EUS) and EUS with fine-needle aspiration (FNA) and increase knowledge of potential adverse events of these procedures
Patients undergoing endoscopic ultrasound (EUS) and EUS with fine-needle aspiration (FNA)
- Awareness of potential adverse events associated with endoscopic ultrasound (EUS) and EUS-guided fine-needle aspiration (FNA), their expected frequency, and the risk factors associated with their occurrence
- Careful patient selection
- Familiarity with the planned procedure and available technology
- Preparation for and management of any adverse events
- Review of complications to reduce future risk and improve overall quality
- Reduction of future adverse events
- Quality improvement
Adverse events are inherent in the performance of endoscopic ultrasound (EUS) and EUS-fine-needle aspiration (FNA). As these procedures assume larger roles in the management of gastrointestinal (GI) and non-GI disorders, the potential for adverse events will likely increase. Knowledge of potential adverse events secondary to EUS and EUS-FNA, their expected frequency, and their associated risk factors may help to minimize their occurrence. Endoscopists are expected to carefully select patients for the appropriate intervention, be familiar with the planned procedure and available technology, and be prepared to manage any adverse events that may arise. Once an adverse event occurs, early recognition and prompt intervention may minimize the morbidity and mortality associated with that adverse event. Review of adverse events as part of a continuing quality improvement process may serve to educate endoscopists, help to reduce the risk of future adverse events, and improve the overall quality of endoscopy.
Institute of Medicine (IOM) National Healthcare Quality Report Categories
Living with Illness
The National Guideline Clearinghouseâ¢ (NGC) does not develop, produce, approve, or endorse the guidelines represented on this site.
All guidelines summarized by NGC and hosted on our site are produced under the auspices of medical specialty societies, relevant professional associations, public or private organizations, other government agencies, health care organizations or plans, and similar entities.
Guidelines represented on the NGC Web site are submitted by guideline developers, and are screened solely to determine that they meet the NGC Inclusion Criteria which may be found at http://www.guideline.gov/about/inclusion-criteria.aspx.
NGC, AHRQ, and its contractor ECRI Institute make no warranties concerning the content or clinical efficacy or effectiveness of the clinical practice guidelines and related materials represented on this site. Moreover, the views and opinions of developers or authors of guidelines represented on this site do not necessarily state or reflect those of NGC, AHRQ, or its contractor ECRI Institute, and inclusion or hosting of guidelines in NGC may not be used for advertising or commercial endorsement purposes.
Readers with questions regarding guideline content are directed to contact the guideline developer.