Establishing Standards for Gastrointestinal Endoscopic-Related Fluoroscopy: An International Expert Consensus Using a Modified Delphi Process
Bibliographic record
Abstract
Aims The use of fluoroscopy in gastrointestinal endoscopic procedures offers valuable insights but also raises concerns about radiation exposure. This study aims to develop evidence-based guidelines for the safe and effective use of fluoroscopy in such procedures, prioritizing the safety of patients and healthcare workers. Methods A modified Delphi method was employed to achieve consensus among 46 experts from six continents. Three rounds of voting were conducted, and consensus was defined as at least 80% agreement. Thirty-one statements achieved consensus in the second round, focusing on patient safety, staff safety, education, pregnancy, and family planning. The statements were rated on a scale of 1 to 10 in the third round. Results In our study, 46 experts, consisting of 34 physicians therapeutic endoscopists and 12 endoscopy nurses, participated from six continents, with 45.6% female representation (n=21). Following three rounds of voting, a total of 43 item statements were generated in the first round, covering various categories including General Considerations, Education, Pregnancy, Family Planning, Patient Safety, and Staff Safety. Out of these, 31 statements achieved consensus after the second round. The accepted statements were categorized into General Considerations (6 questions), Education (10 statements), Pregnancy (4 statements), Family Planning (2 statements), Patient Safety (4 statements), and Staff Safety (5 statements). In the third round, the statements received mean scores ranging from 7.28 to 9.36 on a scale of 1 to 10, with up to 87.18% of responses scoring them as a very high priority. Conclusions This study presents consensus-based standards for the safe use of fluoroscopy in gastrointestinal endoscopic procedures, addressing the well-being of both patients and healthcare workers. These guidelines aim to mitigate the risks associated with radiation exposure while maintaining the benefits of fluoroscopy, ultimately promoting a culture of safety in healthcare settings. Publication History Article published online: 15 April 2024 © 2024. European Society of Gastrointestinal Endoscopy. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.304 | 0.241 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.003 |
| Bibliometrics | 0.008 | 0.004 |
| Science and technology studies | 0.004 | 0.004 |
| Scholarly communication | 0.004 | 0.005 |
| Open science | 0.003 | 0.012 |
| Research integrity | 0.003 | 0.004 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".