A new comprehensive scale for ranking complexity of endoscopic procedures: Table 1
Bibliographic record
Abstract
Introduction Working parties of the ASGE Quality Committee recently published a proposed new lexicon for adverse events (complications), and a separate extensive review of risk factors. The complexity of procedures also affects outcomes. A scale of complexity for ERCP was developed in 20001 and has been used in a modified form.2 Our goal was to update that scale and to develop one for the other main procedures. Methods We made lists of all of the techniques and contexts in which they are used and refined them after review by members of the ASGE Quality Committee and their clinical colleagues. The final lists were then distributed to 75 gastroenterologists in USA, Canada and Britain who were asked to score the items on a scale of 1–4, with 4 being the most complex. They were asked also whether or not to raise the item by one level (to a maximum of 4) if the procedure was done out of normal working hours, or in a child aged less than 3 years, or one that had been unsuccessful before. Results The data for upper endoscopy and for colonoscopy are shown. Those for EUS and ERCP will be presented Conclusion A scale for ranking the complexity of the common endoscopic procedures has been developed and is ready to be tested and validated. This complements lexicons for adverse events and for risk factors that have been published recently from the Quality committee of the ASGE. Table 1 OC-026 Upper endo Level 1 Diagnostic EGD, with or without biopsy/cytology. 2 Dilation esophageal stricture; Treat vascular lesions, hemostasis; Gastric polypectomy, stalked <2 cm; Nutritional support (catheter placement, PEG); Foreign body removal; Push enteroscopy. 3 Gastric polypectomy (stalked >2 cm); Esophageal stent; Dilation duodenal stricture; Duodenal stent; Tumour and Barrett's ablation; Endoscopically assisted Achalasia dilation; Device-assisted enteroscopy (e.g., balloon). 4 Percutaneous Jejunostomy; Resect sessile lesions (EMR/ESD); Crico-pharnygeal myotomy. Colonoscopy 1 Diagnostic (sampling, tattooing), Colonoscopy via ostomy. 2 Polypectomy, stalked <2 cm; Treat vascular lesions, hemostasis; Decompression tube; Banding varices and hemorrhoids. 3 Polypectomy, stalked >2 cm; Stricture dilation; Colonic stent. 4 Percutaneous endoscopic colostomy; Colonic EMR and ESD.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.022 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.007 | 0.005 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.016 | 0.004 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".