Developing a countrywide endoscopy registry: experiences from the National Endoscopy Database Journal: Journal of Gastroenterology and Hepatology

Endoscopy is highly effective for the diagnosis, treatment, and surveillance of gastrointestinal diseases. Variation in procedural quality affects patient outcomes. Professional guidelines recommend monitoring endoscopy performance measures to support quality improvement and facilitate endoscopist training. Procedural data also inform service planning and resource allocation. Uploading data from local endoscopy units to a central national database enables large-scale quality assurance and research. A potential barrier to quality improvement is that manual data collection is time-consuming and operationally challenging. In the UK, the National Endoscopy Database (NED) automatically extracts anonymised endoscopy data from local reporting systems thereby eliminating manual audits. Since its launch in 2019 NED has generated high-impact clinical research and quality improvement outputs and supported structured clinician training. This article provides a roadmap for developing a central endoscopy registry, drawing on the authors' collective experience. It outlines key considerations for team composition, dataset design, technical architecture, and governance. The possible uses of a centralised registry are explored, including quality improvement initiatives with automated delivery of feedback to endoscopists, research on a national scale, and structured training of clinicians. Future applications involving AI integration are considered.