Updated BSG guidelines for cancer surveillance in IBD – improving consensus and changing practice?
Notice bibliographique
Résumé
Introduction BSG guidelines for screening and surveillance in IBD have been recently updated to account for changes in consensus opinion and evidence since their initial publication in 2002.1 2 Changes include use of pancolonic dye spray, suggested intervals between colonoscopies, and use of therapeutic endoscopy. The current work aims to assess contemporary practice, opinion and understanding among gastroenterologists in relation to the updated guidelines. Methods A questionnaire survey was electronically distributed to gastroenterology consultants and trainees within Severn and Wales deaneries. A 31.4% (37/118) response rate was achieved across 14 NHS trusts. Guidelines were available to all respondents. Results Variations in local protocols included the choice of bowel preparation, the number of ‘points’ allocated per colonoscopy (range 1–4), and in the targeting of colonoscopies to endoscopists with a special interest (35% of institutions). Pancolonic dye spray was used routinely by only 30% of respondents, with the majority (60%) employing the previously recommended strategy of taking two to four random biopsies at 10 cm intervals.2 The average number of biopsies taken during routine surveillance colonoscopy ranged from 4 to 50 (mean=18.83). A general consensus with guidelines in respect to the timing of initial screening colonoscopy, and of the surveillance intervals necessary in proctitis and pancolitis was demonstrated. Nonetheless, widespread confusion regarding optimum surveillance intervals in high risk groups (eg, PSC, family history) and in cases where definition of disease extent was unclear (eg, UC extending to sigmoid – classified as left sided disease by Montreal criteria3) was evident. With the notable exception of low grade dysplasia, lesion management was broadly consistent and in keeping with BSG guidelines. Responses were similar in both consultant (n=25) and trainee (n=12) groups. Conclusion A similar study undertaken in relation to the 2002 BSG guidelines highlighted widespread controversy and uncertainty surrounding IBD surveillance.4 Analysis of results from the current work suggest that, although the updated guidelines clarify some areas, notable variations in local and individual practice remain, and areas of confusion persist. In particular a reluctance to use pancolonic dye spray, uncertainty regarding surveillance intervals in high risk groups, a lack of clarity in classification of disease extent, and disparity in management of low grade dysplasia are demonstrated. If these findings are representative of opinion and understanding nationally, it would seem that uniform, quality surveillance in IBD is not yet accepted standard practice.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».