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Quality improvement gastroenterology

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https://www.readbyqxmd.com/read/28417650/assessment-potential-of-a-new-suture-simulator-in-laparoscopic-surgical-skills-training
#1
Tomohira Takeoka, Shuji Takiguchi, Munenori Uemura, Yasuhiro Miyazaki, Tsuyoshi Takahashi, Yukinori Kurokawa, Tomoki Makino, Makoto Yamasaki, Masaki Mori, And Yuichiro Doki
BACKGROUND: The skills necessary for performing effective laparoscopic suturing are difficult to acquire; as a result, simulators for learning these skills are rapidly becoming integrated into surgical training. The aim of the study was to verify whether a new hybrid simulator has the potential to measure skill improvement in young, less experienced gastroenterological surgeons. MATERIAL AND METHODS: The study included 12 surgeons (median age, 29 (27-38)] years; 11 men (91...
April 18, 2017: Minimally Invasive Therapy & Allied Technologies: MITAT
https://www.readbyqxmd.com/read/28344786/united-european-gastroenterology-evidence-based-guidelines-for-the-diagnosis-and-therapy-of-chronic-pancreatitis-hapaneu
#2
REVIEW
J Matthias Löhr, Enrique Dominguez-Munoz, Jonas Rosendahl, Marc Besselink, Julia Mayerle, Markus M Lerch, Stephan Haas, Fatih Akisik, Nikolaos Kartalis, Julio Iglesias-Garcia, Jutta Keller, Marja Boermeester, Jens Werner, Jean-Marc Dumonceau, Paul Fockens, Asbjorn Drewes, Gürlap Ceyhan, Björn Lindkvist, Joost Drenth, Nils Ewald, Philip Hardt, Enrique de Madaria, Heiko Witt, Alexander Schneider, Riccardo Manfredi, Frøkjer J Brøndum, Sasa Rudolf, Thomas Bollen, Marco Bruno
BACKGROUND: There have been substantial improvements in the management of chronic pancreatitis, leading to the publication of several national guidelines during recent years. In collaboration with United European Gastroenterology, the working group on 'Harmonizing diagnosis and treatment of chronic pancreatitis across Europe' (HaPanEU) developed these European guidelines using an evidence-based approach. METHODS: Twelve multidisciplinary review groups performed systematic literature reviews to answer 101 predefined clinical questions...
March 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28334433/dietary-interventions-for-recurrent-abdominal-pain-in-childhood
#3
REVIEW
Tamsin V Newlove-Delgado, Alice E Martin, Rebecca A Abbott, Alison Bethel, Joanna Thompson-Coon, Rebecca Whear, Stuart Logan
BACKGROUND: This is an update of the original Cochrane review, last published in 2009 (Huertas-Ceballos 2009). Recurrent abdominal pain (RAP), including children with irritable bowel syndrome, is a common problem affecting between 4% and 25% of school-aged children. For the majority of such children, no organic cause for their pain can be found on physical examination or investigation. Many dietary inventions have been suggested to improve the symptoms of RAP. These may involve either excluding ingredients from the diet or adding supplements such as fibre or probiotics...
March 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28268235/performance-measures-for-lower-gastrointestinal-endoscopy-a-european-society-of-gastrointestinal-endoscopy-esge-quality-improvement-initiative
#4
Michal F Kaminski, Siwan Thomas-Gibson, Marek Bugajski, Michael Bretthauer, Colin J Rees, Evelien Dekker, Geir Hoff, Rodrigo Jover, Stepan Suchanek, Monika Ferlitsch, John Anderson, Thomas Roesch, Rolf Hultcranz, Istvan Racz, Ernst J Kuipers, Kjetil Garborg, James E East, Maciej Rupinski, Birgitte Seip, Cathy Bennett, Carlo Senore, Silvia Minozzi, Raf Bisschops, Dirk Domagk, Roland Valori, Cristiano Spada, Cesare Hassan, Mario Dinis-Ribeiro, Matthew D Rutter
The European Society of Gastrointestinal Endoscopy and United European Gastroenterology present a short list of key performance measures for lower gastrointestinal endoscopy. We recommend that endoscopy services across Europe adopt the following seven key performance measures for lower gastrointestinal endoscopy for measurement and evaluation in daily practice at a center and endoscopist level: 1 Rate of adequate bowel preparation (minimum standard 90 %); 2 Cecal intubation rate (minimum standard 90 %); 3 Adenoma detection rate (minimum standard 25 %); 4 Appropriate polypectomy technique (minimum standard 80 %); 5 Complication rate (minimum standard not set); 6 Patient experience (minimum standard not set); 7 Appropriate post-polypectomy surveillance recommendations (minimum standard not set)...
April 2017: Endoscopy
https://www.readbyqxmd.com/read/28249809/opportunities-for-improvement-in-the-contemporary-management-of-acute-variceal-hemorrhage-a-systematic-review-of-observational-studies
#5
REVIEW
Elliot B Tapper, Lauren Beste, Michael Curry, Alan Bonder, Akbar Waljee, Sameer Saini
BACKGROUND AND AIMS: Gastroenterologists should strive to improve the outcomes associated with acute variceal hemorrhage (AVH) by optimizing care delivery and clinician preparedness through training. Unfortunately, data regarding contemporary outcomes and management of AVH are limited. METHODS: We performed a systematic review of cohort studies examining outcomes and management of AVH from January 1990 to September 2016. We pooled data on mortality and utilization of medical therapy, endoscopic interventions, balloon tamponade (BT), and salvage procedures (portal decompressive surgery or transjugular portosystemic shunt (TIPS))...
February 26, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28228488/uk-guideline-on-transition-of-adolescent-and-young-persons-with-chronic-digestive-diseases-from-paediatric-to-adult-care
#6
Alenka J Brooks, Philip J Smith, Richard Cohen, Paul Collins, Andrew Douds, Valda Forbes, Daniel R Gaya, Brian T Johnston, Patrick J McKiernan, Charles D Murray, Shaji Sebastian, Monica Smith, Lisa Whitley, Lesley Williams, Richard K Russell, Sara A McCartney, James O Lindsay
The risks of poor transition include delayed and inappropriate transfer that can result in disengagement with healthcare. Structured transition care can improve control of chronic digestive diseases and long-term health-related outcomes. These are the first nationally developed guidelines on the transition of adolescent and young persons (AYP) with chronic digestive diseases from paediatric to adult care. They were commissioned by the Clinical Services and Standards Committee of the British Society of Gastroenterology under the auspices of the Adolescent and Young Persons (A&YP) Section...
February 21, 2017: Gut
https://www.readbyqxmd.com/read/28192101/transforming-gastroenterology-care-with-telemedicine
#7
REVIEW
Corey A Siegel
Health care is changing rapidly, so we must change with the times to develop more efficient, practical, cost-effective, and, importantly, high-quality methods to care for patients. We teach medical students that optimal patient care requires face-to-face interaction to collect information on the patient's history and perform the physical examination. However, management of many patients-especially those with chronic diseases-does not always require physical examination. Telemedicine offers an opportunity to take advantage of technology while leveraging the progressive push toward efficiency and value but also requires the belief that excellent patient care is not always provided in person...
February 10, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28179979/flexible-gastro-intestinal-endoscopy-clinical-challenges-and-technical-achievements
#8
REVIEW
Niehls Kurniawan, Martin Keuchel
Flexible gastro-intestinal (GI) endoscopy is an integral diagnostic and therapeutic tool in clinical gastroenterology. High quality standards for safety, patients' comfort, and efficiency have already been achieved. Clinical challenges and technical approaches are discussed in this short review. Image enhanced endoscopy for further characterization of mucosal and vascular patterns includes dye-spray or virtual chromoendoscopy. For confocal laser endoscopy, endocytoscopy, and autofluorescence clinical value has not yet been finally evaluated...
2017: Computational and Structural Biotechnology Journal
https://www.readbyqxmd.com/read/28139500/variation-in-inflammatory-bowel-disease-care-among-saudi-pediatric-gastroenterologists
#9
Ahmed A Al-Sarkhy
BACKGROUND/AIM: Although international guidelines in inflammatory bowel disease (IBD) management are currently available, variations in IBD care still exist. The aim of this study was to determine the extent of the variation in IBD care among Saudi pediatric gastroenterologists. MATERIALS AND METHODS: A cross-sectional survey was conducted among all pediatric gastroenterologists who were members of the Saudi Society of Pediatric Gastroenterology, Hepatology, and Nutrition (SASPGHAN) from August 2015 to December 2015...
January 2017: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
https://www.readbyqxmd.com/read/28134689/the-care-of-the-colorectal-cancer-survivor
#10
Andrea Cercek, Peter R Holt
PURPOSE OF REVIEW: The gastroenterology literature emphasizes factors that increase colorectal cancer (CRC) incidence but presents little about management after initial CRC treatments. The purpose of this review is to describe the remarkably increasing numbers of CRC survivors in whom surveillance guidelines are often not followed and patient care is fragmented. The gastroenterologist can play an important role in this care to improve prognosis and overall health. RECENT FINDINGS: Existing surveillance recommendations by specialty societies for CRC survivors are fairly consistent but implementation occurs in less than half...
January 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28078798/systematic-review-with-meta-analysis-rifaximin-is-effective-and-safe-for-the-treatment-of-small-intestine-bacterial-overgrowth
#11
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...
March 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28069744/coeliac-disease-screening-is-suboptimal-in-a-tertiary-gastroenterology-setting
#12
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
#13
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...
March 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/27984349/creatively-improving-care-delivery
#14
Brendan M Boyle, Ivor Hill
The medical community has been challenged to improve upon deficiencies in the delivery of patient care. Quality improvement 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 multicenter projects or single-center efforts. Through our willingness to accept the challenge to improve, practitioners within the pediatric gastroenterology community have become leaders in using quality improvement to change practice and improve clinical outcomes...
May 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/27977544/outcomes-from-pediatric-gastroenterology-maintenance-of-certification-using-web-based-modules
#15
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. Each activity was a Web-based module that measured clinical practice data repeatedly over at least 3 months as participants implemented rapid cycle change...
May 2017: 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
#16
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
#17
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
#18
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...
January 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/27855107/first-quality-score-for-referral-letters-in-gastroenterology-a-validation-study
#19
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
#20
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
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