Musculoskeletal injuries among ERCP endoscopists: A canadian survey
Bibliographic record
Abstract
Background: Repair costs for endoscopes range from $3 to $23 per procedure. Echoendoscopes are more complex and more expensive than standard endoscopes. The frequency with which EUS equipment fails, the costs associated with these failures and factors that may contribute to echoendoscope damage have not been defined. Methods: Surveys were sent to 190 endosonographers identified through the ASGE subcommittee on EUS regarding 15 aspects of their EUS practice and instances of echoendoscope failure and repair over the last 12 months. Follow-up faxes and e-mails were sent to encourage participation. Results: Responses were obtained from 59 different medical centers (28%). Reasons for failure: leak 33, mechanical 25, electronic 21, cable 8, optics 6, and other 8. Average annual (AA) # of EUS procedures performed 251 63 (10-1100). AA # of EUS repairs/center 4 1.1 (0-19). AA cost of EUS repairs/center $11,185 3,980 (0-50,000). Average cost per repair $3,273 1,142 (0-17,900). Average repair cost per procedure $68 26. Number of procedures at which repair costs equal purchase price 750. Over 12 months, equipment failure resulted in misdiaguosis in at least one case in 9% (5/55) of centers and resulted in at least one procedure cancellation in 71% (39/55), with a quarter reporting -> 6 cancelled cases. No patient was injured by an echoendoscope failure. Almost every center used the manufacturer for major repairs (52/56) and 77% (38/50) were satisfied with the majority of repairs. "Loaner" echoendoscopes were reported available only about half the time. Subset analysis revealed an inverse relationship between per procedure repair cost and number of procedures, with the highest costs occurring in centers with 2 echoendoscopes. The presence of fellows was associated with lower per-procedure costs. However, fellows were disproportionately employed at high-volume centers. Failures were reported in all available echoendoscopes. No trends were interpretable based on brand, model, or cleaning techniques. Although 91% (50/55) of centers owned their equipment, 43% (24/56) were unaware of their repair costs. Conclusions: EUS equipment failures are common, expensive and represent higher per-procedure costs than for other endoscopes. High-volume centers appear to spend less per procedure for repairs than low-and middle-volume centers. Reimbursement formulas should take into account the significant cost of repairing EUS instruments.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.006 | 0.002 |
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; both teacher heads agree on what is shown here.
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".