Practice Guidance

Quality & Performance Measures

Use AGA’s quality and performance measures to implement AGA guidelines and track the high-quality care being provided to your patients.

AGA’s commitment to quality​

AGA supports gastroenterologists in providing high quality care via improved patient outcomes, increased efficiency and cost-effectiveness.

Current AGA measures

These measures have been through the public comment period, reviewed by the Quality Committee and are ready for alpha testing.

Esophagogastroduodenoscopy (EGD) interval for patients with non-dysplastic Barrett’s esophagus

Systematic biopsies during surveillance EGD in patients with Barrett’s esophagus

Thiopurine methyltransferase (TPMT) testing (enzymatic activity or genotype) in all patients that was performed and results interpreted prior to starting azathioprine or 6 mercaptopurine

Postoperative monitoring for recurrence of Crohn’s disease at six to 12 months after surgical resection in patients with Crohn’s disease

Percentage of patients diagnosed with mild-moderate ulcerative colitis that receive a high-(> 3 g/d) or standard- dose mesalamine (2-3 grams/d) or diazo-bonded 5-ASA rather than low dose mesalamine (< 2 g/d), sulfasalazine or no treatment

Sustained virological response (SVR) in the treatment of hepatitis C infection

Percentage of patients aged 18 years and older with a diagnosis of acute pancreatitis who receive oral feeding within 24 hours of admission to the hospital

Percentage of patients aged 18 years and older who are hospitalized with acute pancreatitis and are eligible for enteral nutrition but receive parenteral nutrition (This measure captures the frequency of deviations from the standard of care)

Percentage of patients aged 18 years and older with a diagnosis of acute biliary pancreatitis who undergo cholecystectomy during the same hospital admission

Measures in development

These measures have been developed but have not been through the public comment period or have not been voted as approved by the AGA Quality Committee.

Percentage of surgical pathology reports for primary colorectal, endometrial, gastroesophageal or small bowel carcinoma, biopsy or resection, that contain impression or conclusion of or recommendation for testing of mismatch repair (MMR) by immunohistochemistry (biomarkers MLH1, MSH2, MSH6, and PMS2), or microsatellite instability (MSI) by DNA-based testing status, or both

Read our latest commentary in Gastroenterology: AGA Institute Quality Measure Development for the Diagnosis and Management of COVID-19

How AGA develops performance measures

AGA has been instrumental in assuring that GI has a place at the table concerning quality, influencing the national agenda through developing, specifying, maintaining, testing and implementing quality measures, and through membership and participation in the Physician Consortium for Performance Improvement, the Centers for Medicare and Medicaid Services (CMS) Quality Payment Program and other national organizations.​

The AGA Institute Quality Committee (QC) provides clinical and methodological expertise and oversight for the development, specification, maintenance and testing of AGA’s performance measures.

AGA follows a process for prioritizing and developing measures from AGA guidelines. A measure testing protocol is in development to guide how measures are tested for implementation. Periodically, the AGA Quality Committee issues calls for new measure topics of interest to AGA members. Public comment periods are held to receive feedback from gastroenterologists and others interested in new AGA measures.

Get involved: join the measure testing collaborative

The testing process includes accessing measure specifications for new measures developed by the AGA Quality Committee based on the most recent guidelines, providing detailed, qualitative assessments of measures’ usability and feasibility, and providing de-identified data for analysis. We are seeking a minimum of 30 providers that are willing to participate in an ongoing basis for all digestive disease conditions. To qualify for a particular measure, you will need to meet a 10-patient threshold (the 10-patient threshold is the minimum number of patients that is allowed to be considered reliable for testing). If you are interested in joining the collaborative, please contact David Godzina: dgodzina@gastro.org.

Additional resources

Choosing Wisely® Initiative

Choosing Wisely was created to help physicians, patients and other health care stakeholders think and talk about overuse or misuse of health care resources in the U.S.

  1. For pharmacological treatment of patients with gastroesophageal reflux disease (GERD), long-term acid suppression therapy (proton pump inhibitors or histamine2 receptor antagonists) should be titrated to the lowest effective dose needed to achieve therapeutic goals.
  2. Do not repeat colorectal cancer screening (by any method) in average-risk individuals for 10 years after a high-quality colonoscopy that does not detect neoplasia.
  3. Do not repeat surveillance colonoscopy for at least five years for average-risk patients who have one or two small (<1cm) adenomatous polyps, without high-grade dysplasia or villous histology, completely removed via a high-quality colonoscopy.
  4. For a patient who is diagnosed with Barrett’s esophagus, who has undergone a second endoscopy that confirms the absence of dysplasia on biopsy, a follow-up surveillance examination should not be performed in less than three years as per published guidelines.
  5. For a patient with functional abdominal pain syndrome (as per ROME III criteria) computed tomography (CT) scans should not be repeated unless there is a major change in clinical findings or symptoms.

Colonoscopy is the most accurate test for cancer of the colon and rectum, proven to detect the disease early and save lives. But even a very good test can be done too often. Here’s when you need it, and when you might not.

Watch modules with scenarios to help you practice guideline-based medicine.

Constipation related data analysis

AGA Pocket Guides

Official AGA Institute quick-reference tools provide healthcare providers and students with instant access to current guidelines and clinical care pathways in a clear, concise format. AGA Institute pocket guides are available in print and digital form.

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Join the fight for the future of GI

The AGA PAC works to obtain reasonable Medicare reimbursement rates, increase federal funding for biomedical research, encourage medical liability reform and ease regulatory burdens on gastroenterologists.