Endoscopic grading of gastric intestinal metaplasia (EGGIM) effectively identifies extensive disease with high sensitivity and specificity, enhancing patient risk stratification for surveillance.

• Pooled sensitivity of EGGIM is 90% and specificity is 92%, based on 1,143 patients across seven studies using narrow-band or blue light imaging.
• The diagnostic odds ratio is 105.93, with an AUC of 0.96, indicating strong performance for identifying extensive gastric intestinal metaplasia.

These findings suggest that EGGIM could be integrated into endoscopic practice for real-time assessment, but further validation is needed.