The Dutch national ERCP quality registration using self-assessment does not correlate with clinical ERCP outcome

Background: Quality measurement of endoscopic procedures is an actual and important subject. In the Netherlands endoscopists are obligated to register their Endoscopic Retrograde Cholangiopancreatography (ERCP) performances in a National ERCP quality registration (NEQR). NEQR is a self-assessment that evaluates ERCP quality and volume per centre and endoscopist, but complications and outcome of the procedure are both not registered in NEQR. The aim of this study is to examine whether NEQR correlates with objective post-ERCP clinical outcome in a tertiary referral centre. Material and methods: A retrospective cohort study of all ERCPs performed at a tertiary referral centre in 2016. Correlations between NEQR self-assessments and post-ERCP complications and mortality were measured. Results: 333 procedures were performed, of which 254 were registered in the NEQR (76.3%). No significant correlations were found between the subjective self- assessment and objective post-ERCP outcomes. Of all 333 procedures the total post-ERCP complication rate was 13.5% and the ERCP-related 30-day mortality rate was 0.6%. Conclusions: The currently used NEQR does not correlate with post-procedural clinical outcomes. Clinical outcome measures in a 30-day post-ERCP period, including complications, should be implemented to improve the usefulness of this specific quality registration.