TPT 6.12 From Procedure Metrics to Pathway Governance: Construct Validity of “Documented Discussion of Management Options Prior to Index ERCP” As a Quality Indicator in Bile Duct Stone Disease

Clicks: 29
ID: 323936
2026
Free PDF
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This article has not been analysed, so there is no overall score — reader engagement is measured and shown alongside.
AI Quality Assessment
Not analyzed
Readership in this journal
Steady

Ranked #76 of 432 articles by views in the british journal of surgery

Most read Least read

Bar heights use a square-root scale. Only the 120 most-read articles are drawn; the journal has 432 in total.

Mint this article as an NFT
Not yet minted

Create a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.

5 SUSD one-off · no wallet required
Sign in to mint
Abstract
Abstract Background ERCP quality assurance is moving from procedure metrics to pathway governance. For choledocholithiasis, ERCP and single-stage laparoscopic common bile duct exploration (LCBDE) are both accepted duct-clearance strategies where expertise exists; governance depends on a retrievable record that options were considered before the index procedure. We aimed to develop and evaluate the construct validity of a pragmatic indicator for documented discussion of duct-clearance options before index ERCP and to benchmark performance against contemporaneous LCBDE. Methods Retrospective cohort of all index ERCPs for choledocholithiasis (2023–2024) across two acute hospitals in a UK health board, plus contemporaneous LCBDEs. Indicator: explicit pre-procedure documentation that management options were discussed. Construct validity was assessed using a prespecified argument with hypothesis tests for feasibility, response process, convergent comparator association, and negative controls. Results 356 ERCPs and 38 LCBDEs were included; the indicator was auditable in 100%. ERCP attainment was 20.5% (73/356; 95% CI 16.6% to 25.0). Documentation co-occurred with a specific recorded rationale for not offering LCBDE (100% vs 11.3%; p<0.001) and differed in known-groups comparison (LCBDE 100% vs ERCP 20.5%; p<0.001). Negative controls showed no material associations, supporting bounded interpretation as documentation reliability. Conclusion A feasible indicator with construct validity signals consistent with an auditable documentation bundle at the ERCP decision point. Low attainment for index ERCPs identifies a target for measurement-for-improvement and supports quarterly run-chart monitoring, without conflating documentation with consent quality or clinical outcomes.
Reference Key
openalex_W7172521230 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Makthum Muwafikha Ismail, Charlotte Smith, Khurram Shahzad Khan
Are you one of these authors? Claim your profile
Journal the british journal of surgery
Year 2026
DOI
10.1093/bjs/znag087.235
URL
https://doi.org/10.1093/bjs/znag087.235
Keywords Keywords not found

Citations

No citations found. To add a citation, contact the admin at info@scimatic.org

Comments

No comments yet. Be the first to comment on this article.