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Quality improvement gastroenterology

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https://www.readbyqxmd.com/read/28078798/systematic-review-with-meta-analysis-rifaximin-is-effective-and-safe-for-the-treatment-of-small-intestine-bacterial-overgrowth
#1
REVIEW
L Gatta, C Scarpignato
BACKGROUND: Small intestinal bacterial overgrowth (SIBO) is a heterogeneous syndrome, characterised by an increased number and/or abnormal type of bacteria in the small bowel. Over the past decades, rifaximin has gained popularity for this indication despite its use is not evidence based. AIM: To perform a systematic review and meta-analysis to summarise evidence about the efficacy and safety of rifaximin to eradicate SIBO in adult patients. METHODS: MEDLINE, EMBASE, CCRCT, Scopus and Web of Science were searched from inception to March 16, 2015 for RCTs and observational studies...
January 12, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28069744/coeliac-disease-screening-is-suboptimal-in-a-tertiary-gastroenterology-setting
#2
Heba Iskandar, Darrell M Gray, Hongha Vu, Faiz Mirza, Mary Katherine Rude, Kara Regan, Adil Abdalla, Srinivas Gaddam, Sami Almaskeen, Michael Mello, Evelyn Marquez, Claire Meyer, Ahmed Bolkhir, Navya Kanuri, Gregory Sayuk, C Prakash Gyawali
BACKGROUND AND AIMS: Coeliac disease (CD) is widely prevalent in North America, but case-finding techniques currently used may not be adequate for patient identification. We aimed to determine the adequacy of CD screening in an academic gastroenterology (GI) practice. METHODS: Consecutive initial visits to a tertiary academic GI practice were surveyed over a 3-month period as a fellow-initiated quality improvement project. All electronic records were reviewed to look for indications for CD screening according to published guidelines...
January 9, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28029300/hospice-utilization-and-its-effect-on-acute-care-needs-at-the-end-of-life-in-medicare-beneficiaries-with-hepatocellular-carcinoma
#3
Hanna K Sanoff, YunKyung Chang, Melissa Reimers, Jennifer L Lund
INTRODUCTION: Hepatocellular carcinoma (HCC) is a poor-prognosis cancer with a high symptom burden. Multidisciplinary HCC care is complex and unique in cancer medicine. We sought to determine whether the distinct process affects hospice use and how hospice affects end-of-life acute care utilization. PATIENTS AND METHODS: Patients dying after HCC diagnosed from 2004 to 2011 were identified within SEER-Medicare. Hospice use and associated factors were described using logistic regression...
December 28, 2016: Journal of Oncology Practice
https://www.readbyqxmd.com/read/27984349/creatively-improving-care-delivery
#4
Brendan M Boyle, Ivor Hill
The medical community has been challenged to improve upon deficiencies in the delivery of patient care. Quality improvement (QI) methods are therefore increasingly used in everyday clinical practice. As demonstrated in this review, creative and impactful improvement projects within pediatric gastroenterology can be successfully achieved as either multi-center projects or single-center efforts. Through our willingness to accept the challenge to improve, practitioners within the pediatric GI community have become leaders in using quality improvement to change practice and improve clinical outcomes...
December 15, 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/27977544/outcomes-from-pediatric-gastroenterology-maintenance-of-certification-using-web-based-modules
#5
Josephine Sheu, Stanford Chun, Emily O'Day, Sara Cheung, Rusvelda Cruz, Jenifer R Lightdale, Douglas S Fishman, Athos Bousvaros, Jeannie S Huang
OBJECTIVES: Beginning in 2013, the North American Society of Pediatric Gastroenterology Hepatology and Nutrition (NASPGHAN) sponsored and developed subspecialty-field specific quality improvement (QI) activities to provide Part 4 Maintenance of Certification (MOC) credit for ongoing certification of pediatric gastroenterologists by the American Board of Pediatrics (ABP). Each activity was a web-based module that measured clinical practice data repeatedly over at least 3 months as participants implemented rapid cycle change...
December 13, 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/27965824/participants-perspectives-on-mindfulness-based-cognitive-therapy-for-inflammatory-bowel-disease-a-qualitative-study-nested-within-a-pilot-randomised-controlled-trial
#6
Mariyana Schoultz, Leah Macaden, Gill Hubbard
BACKGROUND: Mindfulness-based interventions have shown to improve depression and anxiety symptoms as well as quality of life in patients with inflammatory bowel disease (IBD). However, little is known about the experiences of this group of patients participating in mindfulness interventions. This paper sets out to explore the perspectives of patients with IBD recruited to a pilot randomised controlled trial (RCT) of mindfulness-based cognitive therapy (MBCT) about the intervention. METHODS: In a qualitative study nested within a parallel two-arm pilot RCT of mindfulness-based cognitive therapy for patients with IBD, two focus group interviews (using the same schedule) and a free text postal survey were conducted...
2016: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/27941520/self-management-for-patients-with-inflammatory-bowel-disease-in-a-gastroenterology-ward-in-china-a-best-practice-implementation-project
#7
Ruo-Bing Chen
BACKGROUND: Globally, there is an increasing incidence of inflammatory bowel disease. It is very important for patients to be involved with self-management that can optimize personal heath behavior to control the disease. OBJECTIVES: The aim of this project was to increase nursing staff knowledge of inflammatory bowel disease discharge guidance, and to improve the quality of education for discharged patients, thereby improving their self-management. METHODS: A baseline audit was conducted by interviewing 30 patients in the gastroenterology ward of Huadong Hospital, Fudan University...
November 2016: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/27933718/constipation-in-older-people-a-consensus-statement
#8
Anton Emmanuel, Francesco Mattace-Raso, Maria Cristina Neri, Karl-Uwe Petersen, Enrique Rey, June Rogers
BACKGROUND AND AIMS: Chronic constipation is a serious medical condition that affects 30%-40% of people over 60 years old. Although not normally life threatening, constipation reduces quality of life by the same extent as diabetes and osteoarthritis. There are currently no Europe-wide guidelines for treating constipation in older people, although there is some country-level guidance for the general population. We have evaluated the existing guidance and best clinical practice to improve the care of older people with constipation...
December 9, 2016: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/27855107/first-quality-score-for-referral-letters-in-gastroenterology-a-validation-study
#9
Sigrun Losada Eskeland, Cathrine Brunborg, Birgitte Seip, Kristine Wiencke, Øistein Hovde, Tanja Owen, Erik Skogestad, Gert Huppertz-Hauss, Fred-Arne Halvorsen, Kjetil Garborg, Lars Aabakken, Thomas de Lange
OBJECTIVE: To create and validate an objective and reliable score to assess referral quality in gastroenterology. DESIGN: An observational multicentre study. SETTING AND PARTICIPANTS: 25 gastroenterologists participated in selecting variables for a Thirty Point Score (TPS) for quality assessment of referrals to gastroenterology specialist healthcare for 9 common indications. From May to September 2014, 7 hospitals from the South-Eastern Norway Regional Health Authority participated in collecting and scoring 327 referrals to a gastroenterologist...
October 8, 2016: BMJ Open
https://www.readbyqxmd.com/read/27824308/-comorbidity-of-psychiatric-disorders-and-the-characteristics-of-the-therapy-of-the-hospitalized-patients
#10
Balazs Mora, Laszlo Peter
The aim of our retrospective study was to evaluate the diagnostic and therapeutic characteristics of 100 patients who were admitted in our psychiatric department from an index date. Previous investigation showed high prevalence of comorbidity in patients with psychiatric disorders. The most common psychiatric comorbidities included dementia (20%), alcohol dependence (14%) and unipolar depression (8%). The presence of somatic diseases was also high (73%), including cardiovascular (55%), endocrine (30%), neurological (17%), and gastroenterological (16 %) comorbid disorders...
September 2016: Neuropsychopharmacologia Hungarica
https://www.readbyqxmd.com/read/27761565/institute-for-scientific-information-indexed-biomedical-journals-of-saudi-arabia-their-performance-from-2007-2014
#11
Dileep K Rohra, Vikram K Rohra, Peter Cahusac
To compare the journal impact factor (JIF) and Eigenfactor score (ES) of Institute for Scientific Information (ISI)-indexed biomedical journals published from the Kingdom of Saudi Arabia (KSA) over the last 8 years. Methods: This is a retrospective study, conducted at Alfaisal University, Riyadh, KSA from January to March 2016. The Journal Citation Reports of ISI Web of Knowledge were accessed, and 6 Saudi biomedical journals were included for analysis. Results: All Saudi journals have improved their IF compared with their baseline...
November 2016: Saudi Medical Journal
https://www.readbyqxmd.com/read/27761233/using-best-practice-to-create-a-pathway-to-improve-management-of-irritable-bowel-syndrome-aiming-for-timely-diagnosis-effective-treatment-and-equitable-care
#12
Marianne Williams, Yvonne Barclay, Rosie Benneyworth, Steve Gore, Zoe Hamilton, Rudi Matull, Iain Phillips, Leah Seamark, Kate Staveley, Steve Thole, Emma Greig
BACKGROUND: Irritable bowel syndrome (IBS) costs the National Health Service almost £12 million per annum. Despite national guidelines advising primary care management, these have failed to stem secondary care referrals of patients with likely IBS for unnecessary and costly assessment and investigation without necessarily achieving resolution of their symptoms. METHODS: In 2011, an integrated team from primary and secondary care developed a business case using baseline data to create a Somerset-wide IBS pathway using Clinical Commissioning Group funding...
October 2016: Frontline Gastroenterology
https://www.readbyqxmd.com/read/27755268/variation-in-care-of-inflammatory-bowel-diseases-patients-in-crohn-s-and-colitis-foundation-of-america-partners-role-of-gastroenterologist-practice-setting-in-disease-outcomes-and-quality-process-measures
#13
Kimberly N Weaver, Michael D Kappelman, Robert S Sandler, Christopher F Martin, Wenli Chen, Kristen Anton, Millie D Long
BACKGROUND: As variation in care has previously been linked to quality, we aimed to describe variations in inflammatory bowel diseases care by gastroenterology (GI) practice setting. METHODS: We performed a cross-sectional study within the Crohn's and Colitis Foundation of America Partners and used bivariate analyses to compare patient characteristics by GI practice setting (GI-academic [GIA], GI-private, or GI-other). Regression models were used to describe the effects of provider type on steroid use, disease activity, and the quality of life...
November 2016: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/27752319/-the-constipation-conundrum-improving-recognition-of-constipation-on-a-gastroenterology-ward
#14
Robert Jackson, Philip Cheng, Sarah Moreman, Nicola Davey, Lisa Owen
Constipation is a common and often overlooked problem, but it can cause serious complications for patients including pain, nausea, urinary retention, and prolonged hospital admission. There are no recognised criteria for the diagnosis of constipation in the acute hospital setting, and it is often the role of the ward doctor to identify and manage this problem. Completion and monitoring of "stool charts" by nursing and medical staff is key to proper recognition and management of constipation. A baseline study found that while charts were completed well, they were only monitored by doctors 17...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27697869/improving-the-well-being-of-men-by-evaluating-and-addressing-the-gastrointestinal-late-effects-eagle-of-radical-treatment-for-prostate-cancer-study-protocol-for-a-mixed-method-implementation-project
#15
Sophia Taylor, Weyinmi Demeyin, Ann Muls, Catherine Ferguson, Damian J J Farnell, David Cohen, Jervoise Andreyev, John Green, Lesley Smith, Sam Ahmedzai, Sara Pickett, Annmarie Nelson, John Staffurth
INTRODUCTION: Radiotherapy treatment for prostate cancer can cause bowel problems, which may lead to severe difficulties for cancer survivors including limiting travel, work or socialising. These symptoms can appear at any time following radiotherapy. This study focuses on the early identification and protocol-based management of effects known to cause long-term, or even permanent, changes to the well-being of prostate cancer survivors. The rationale of this study is to improve the care offered to men and their families following pelvic radiotherapy for prostate cancer...
October 3, 2016: BMJ Open
https://www.readbyqxmd.com/read/27622698/variation-in-preventive-care-in-children-receiving-chronic-glucocorticoid-therapy
#16
Matthew L Basiaga, Evanette K Burrows, Michelle R Denburg, Kevin E Meyers, Andrew B Grossman, Petar Mamula, Robert W Grundmeier, Jon M Burnham
OBJECTIVE: To assess preventive care measure prescribing in children exposed to glucocorticoids and identify prescribing variation according to subspecialty and patient characteristics. STUDY DESIGN: Retrospective cohort study of children initiating chronic glucocorticoids in the gastroenterology, nephrology, and rheumatology divisions at a pediatric tertiary care center. Outcomes included 25-hydroxyvitamin D (25OHD) and lipid testing, pneumococcal polysaccharide (PPV) and influenza vaccination, and stress dose hydrocortisone prescriptions...
December 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27600190/quality-of-meta-analyses-in-major-leading-gastroenterology-and-hepatology-journals-a-systematic-review
#17
Pengfei Liu, Yuanyu Qiu, Yuting Qian, Xiao Chen, Yiran Wang, Jin Cui, Xiao Zhai
BACKGROUND AND AIM: To appraise the current reporting methodological quality of meta-analyses in five leading gastroenterology and hepatology journals, and to identify the variables associated with the reporting quality. METHODS: We systematically searched the literature of meta-analyses in Gastroenterology, Gut, Hepatology, Journal of Hepatology (J HEPATOL) and American Journal of Gastroenterology (AM J GASTROENTEROL) from 2006 to 2008 and from 2012 to 2014. Characteristics were extracted based on the PRISMA statement and the AMSTAR tool...
September 6, 2016: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/27588295/quality-assurance-in-endoscopy-which-parameters
#18
REVIEW
Ulrike W Denzer
BACKGROUND: The verbalisation of quality standards and parameters by medical societies are relevant for qualitative improvement but may also be an instrument to demand more resources for health care or be a unique characteristic. Within the health care system 3 different quality levels can be defined: structure, process and result quality. METHODS: The current S2k guideline of the German Society for Gastroenterology (quality requirements for gastrointestinal endoscopy) AWMF registry no...
February 2016: Visceral Medicine
https://www.readbyqxmd.com/read/27579299/the-quality-of-colonoscopy-reporting-in-usual-practice-are-endoscopists-reporting-key-data-elements
#19
S D Hadlock, N Liu, M Bernstein, M Gould, L Rabeneck, A Ruco, R Sutradhar, J M Tinmouth
Background. High quality reporting of endoscopic procedures is critical to the implementation of colonoscopy quality assurance programs. Objective. The aim of our research was to (1) determine the quality of colonoscopy (CS) reporting in "usual practice," (2) identify factors associated with good quality reporting, and (3) compare CS reporting in open-access and non-open-access procedures. Methods. 557 CS reports were randomly selected and assigned a score based on the number of mandatory data elements included in the report...
2016: Canadian Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27485483/european-society-of-gastrointestinal-endoscopy-establishing-the-key-unanswered-research-questions-within-gastrointestinal-endoscopy
#20
Colin J Rees, Wee Sing Ngu, Jaroslaw Regula, Raf Bisschops, Adrian Saftoiu, Evelien Dekker, Ian Gralnek, Mihai Ciocirlan, Mario Dinis-Ribeiro, Rodrigo Jover, Søren Meisner, Cristiano Spada, Cesare Hassan, Roland Valori, Tomas Hucl, Olivier Le Moine, Dirk Domagk, Michal F Kaminski, Michael Bretthauer, Matthew D Rutter, Lars Aabakken, Thierry Ponchon, Paul Fockens, Peter D Siersema
Background and study aim: Gastrointestinal endoscopy is a rapidly evolving research field. The European Society of Gastrointestinal Endoscopy (ESGE) plays a key role in shaping opinion and endoscopy activity throughout Europe and further afield. Establishing key unanswered questions within the field of endoscopy and prioritizing those that are important enables researchers and funders to appropriately allocate resources. Methods: Over 2 years, the ESGE Research Committee gathered information on research priorities and refined them through a modified Delphi approach...
October 2016: Endoscopy
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