Colonoscopy is a widely performed procedure with procedural volumes increasing annually throughout the world. Many procedures are now performed as part of colorectal cancer screening programmes. ...Colonoscopy should be of high quality and measures of this quality should be evidence based. New UK key performance indicators and quality assurance standards have been developed by a working group with consensus agreement on each standard reached. This paper reviews the scientific basis for each of the quality measures published in the UK standards.
In this correspondence we respond to critique of our randomized trial of Covid-19 transmission in fitness centers. The trial was performed in Norway during May and June 2020.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Abstract
The European Society of Gastrointestinal Endoscopy (ESGE) together with the United European Gastroenterology (UEG) recently developed a short list of performance measures for small-bowel ...endoscopy (i. e. small-bowel capsule endoscopy and device-assisted enteroscopy) with the final goal of providing endoscopy services across Europe with a tool for quality improvement. Six key performance measures for both small-bowel capsule endoscopy and for device-assisted enteroscopy were selected for inclusion, with the intention being that practice at both a service and endoscopist level should be evaluated against them. Other performance measures were considered to be less relevant, based on an assessment of their overall importance, scientific acceptability, and feasibility. Unlike lower and upper gastrointestinal endoscopy, where performance measures had already been identified, this is the first time that small-bowel endoscopy quality measures have been proposed.
Evidence for colorectal cancer screening Bretthauer, Michael, MD PhD
Baillière's best practice & research. Clinical gastroenterology,
08/2010, Volume:
24, Issue:
4
Journal Article
Peer reviewed
The incidence of colorectal cancer (CRC) has been increasing during the past decades, and the lifetime risk for CRC in industrialised countries is about 5%. CRC is a good candidate for screening, ...because it is a disease with high prevalence, has recognised precursors, and early treatment is beneficial. This paper outlines the evidence for efficacy from randomised trials for the most commonly used CRC screening tests to reduce CRC incidence and mortality in the average-risk population. Four randomised trials have investigated the effect of guaiac-based fecal occult blood screening on CRC mortality, with a combined CRC mortality risk reduction of 15–17% in an intention-to-screen analysis, and 25% for those people who attended screening. Flexible sigmoidoscopy screening has been evaluated in three randomised trials. The observed reduction in CRC incidence varied between 23 and 80%, and between 27 and 67% for CRC mortality, respectively (intention-to-screen analyses) in the trials with long follow-up time. No randomised trials exist in other CRC screening tools, included colonoscopy screening. FOBT and flexible sigmoidoscopy are the two CRC screening methods which have been tested in randomised trials and shown to reduce CRC mortality. These tests can be recommended for CRC screening.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Abstract
The European Society of Gastrointestinal Endoscopy and United European Gastroenterology present a short list of key performance measures for endoscopic ultrasound (EUS) and endoscopic ...retrograde cholangiopancreatography (ERCP). We recommend that endoscopy services across Europe adopt the following seven key and one minor performance measures for EUS and ERCP, for measurement and evaluation in daily practice at center and endoscopist level:
1
Adequate antibiotic prophylaxis before ERCP (key performance measure, at least 90 %);
2
Antibiotic prophylaxis before EUS-guided puncture of cystic lesions (key performance measure, at least 95 %);
3
Bile duct cannulation rate (key performance measure, at least 90 %);
4
Tissue sampling during EUS (key performance measure, at least 85 %);
5
Appropriate stent placement in patients with biliary obstruction below the hilum (key performance measure, at least 95 %);
6
Bile duct stone extraction (key performance measure, at least 90 %);
7
Post-ERCP pancreatitis (key performance measure, less than 10 %).
8
Adequate documentation of EUS landmarks (minor performance measure, at least 90 %).
This present list of quality performance measures for ERCP and EUS recommended by ESGE should not be considered to be exhaustive: it might be extended in future to address further clinical and scientific issues.
Time to abandon early detection cancer screening Adami, Hans‐Olov; Kalager, Mette; Valdimarsdottir, Unnur ...
European journal of clinical investigation,
March 2019, Volume:
49, Issue:
3
Journal Article
Peer reviewed
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BFBNIB, DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK
Correspondence to M Bretthauer michael.bretthauer@medisin.uio.no What you need to know Relative effects of treatments are often described in patient encounters, scientific journals, and mass media, ...although used alone to guide decision making they are insufficient and potentially misleading Absolute treatment effects together with the absolute risk of disease one wants to prevent or treat are more informative and should be used instead Discussions about action thresholds for absolute disease risk and absolute treatment effects are important in patient encounters and elsewhere in the healthcare system Ms Olsen is a 65 year old woman with hypercholesterolaemia and hypertension. What is the absolute risk of harms and side effects (eg, diarrhoea or muscle pain) of taking a statin for Ms Olsen in the next 10 or 15 years, and what is the burden for her to take the treatment (eg, costs, check-up appointments, downstream testing, and how statin therapy may affect her quality of life through potential fear of being at risk for disease8)? ...to estimate her absolute risk of a cardiovascular event, eg, by using a 10 year risk calculator.11 Over a 10 year period, her risk of having a heart attack or stroke is about 6% Secondly, to apply the expected reduction to the estimated absolute risk (6%). Let’s say that the 50% reduction as suggested by her doctor is accurate (although it may be more like 20% to 25%12), reducing her risk by half would give her a risk difference of 3% Thirdly, to tell her that her risk of having a major cardiovascular event is 3% if she chooses to use a statin Fourthly, to inform her about the absolute frequency of side effects of statin therapy, eg, a 5% risk of muscle pain and 10% risk of digestive problems, such as constipation, diarrhoea, or bloating.
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