A regional EUS service using a collaborative network

Gordon, Harriet; Lloyd, D; Higginson, Antony; McCrudden, Raymond; Bent, Clare; Shek, Fanny; Beable, Richard; Al-Badri, Adnan; Green, B; Jaynes, Eleanor; Foria, B; Stacey, Bernard

doi:10.1136/flgastro-2016-100716

Cited by 5 publications

(5 citation statements)

References 7 publications

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“…Small-volume centers that work together as a network can perform comparably to high volume centers. For this reason, it is advised that new EUS programs remain in an EUS network that has the potential to fulfill the desired service provision out-lined by BSG [95]. For example, the Wessex EUS group maintains collaboration among eight endoscopists working in four centers.…”

Section: Recommendation 21mentioning

confidence: 99%

Curriculum for diagnostic endoscopic ultrasound training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

Badaoui,

Teles de Campos,

Fusaroli

et al. 2023

Endoscopy

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Main RecommendationsThe European Society of Gastrointestinal Endoscopy (ESGE) has recognized the need to formalize and enhance training in diagnostic endoscopic ultrasound (EUS). This manuscript represents the outcome of a formal Delphi process resulting in an official Position Statement of the ESGE and provides a framework to develop and maintain skills in diagnostic EUS. This curriculum is set out in terms of the prerequisites prior to training; the recommended steps of training to a defined syllabus; the quality of training; and how competence should be defined and evidenced before independent practice. 1 Trainees should have achieved competence in upper gastrointestinal endoscopy before training in diagnostic EUS. 2 The development of diagnostic EUS skills by methods that do not involve patients is advisable, but not mandatory, prior to commencing formal training in diagnostic EUS. 3 A trainee’s principal trainer should be performing adequate volumes of diagnostic EUSs to demonstrate maintenance of their own competence. 4 Training centers for diagnostic EUS should offer expertise, as well as a high volume of procedures per year, to ensure an optimal level of quality for training. Under these conditions, training centers should be able to provide trainees with a sufficient wealth of experience in diagnostic EUS for at least 12 months. 5 Trainees should engage in formal training and supplement this with a range of learning resources for diagnostic EUS, including EUS-guided fine-needle aspiration and biopsy (FNA/FNB). 6 EUS training should follow a structured syllabus to guide the learning program. 7 A minimum procedure volume should be offered to trainees during diagnostic EUS training to ensure that they have the opportunity to achieve competence in the technique. To evaluate competence in diagnostic EUS, trainees should have completed a minimum of 250 supervised EUS procedures: 80 for luminal tumors, 20 for subepithelial lesions, and 150 for pancreaticobiliary lesions. At least 75 EUS-FNA/FNBs should be performed, including mostly pancreaticobiliary lesions. 8 Competence assessment in diagnostic EUS should take into consideration not only technical skills, but also cognitive and integrative skills. A reliable valid assessment tool should be used regularly during diagnostic EUS training to track the acquisition of competence and to support trainee feedback. 9 A period of supervised practice should follow the start of independent activity. Supervision can be delivered either on site if other colleagues are already practicing EUS or by maintaining contacts with the training center and/or other EUS experts. 10 Key performance measures including the annual number of procedures, frequency of obtaining a diagnostic sample during EUS-FNA/FNB, and adverse events should be recorded within an electronic documentation system and evaluated.

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Section: Recommendation 21mentioning

confidence: 99%

Curriculum for diagnostic endoscopic ultrasound training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

Badaoui,

Teles de Campos,

Fusaroli

et al. 2023

Endoscopy

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“…Finally, as trainees are encouraged to develop sub-specialty interest, it is timely to see how regional expertise can develop. Gordon et al 5 describe how a network can be developed to allow expertise to be shared across a region. Specifically considering endoscopic ultrasound and fine needle aspiration of solid pancreatic lesions they show that such networks can perform to the same standard as high-volume centres.…”

Section: Frontline Gastroenterology and The Gi Traineementioning

confidence: 99%

Highlights from this issue

Emmanuel¹

2016

Frontline Gastroenterol

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“…Introduction Endoscopic ultrasound (EUS) guided sampling of advanced malignant pancreatic lesions is increasingly being performed in order to confirm malignancy prior to chemotherapy and or treatment. Meta-analysis of 33 studies examining solid lesion EUS FNA tissue acquisition in 4984 patients showed a pooled sensitivity of 85%, increasing to 91% if suspicious atypia was included 1 . Higher sensitivities have been demonstrated in large volume single operator centres where sensitivities of 92-97% 2,3 have been reported.…”

Section: Pth-096 the Sensitivity Of Eus Fna Of Solid Pancreatic Lesiomentioning

confidence: 99%

PTH-094 Benefit Of Real Time Cytological Examination In Eus Guided Biopsy Of Suspected Pancreatic Malignancy

Lloyd

Al-Badri

Gordon

2014

Gut

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(highest vs. lowest category HR=1.98, 95% CI: 0.94-4.16, p = 0.07, trend HR=1.23, 95% CI: 0.96-1.57, p = 0.10) and when BMI was included (trend HR=1.21, 95% CI: 0.94-1.55, p = 0.13). Conclusion The association between PA and cancer risk is dependent on the age at which PA is measured. This possibly reflects occupational activity and differences in general medical health with age or residual confounding. The associations were similar when adjusted for BMI, suggesting an independent mechanism of PA. If the inverse association of increased PA in younger participants is causal, one in six cases of pancreatic cancer might be prevented by encouraging more PA. Aetiological studies should measure PA at different ages when investigating pancreatic cancer. Disclosure of Interest None Declared. Introduction Chromogranin A (CgA) is considered as the best general marker for the diagnosis and follow-up of neuroendocrine tumours (NETs) and is also of prognostic value. In literature, there are no available studies which analysed the role of CgA as a predictor of radiological disease progression in all NETs. Present study investigates the prognostic value of CgA as a predictor of radiological disease progression in NET patients. Methods Patients with metastatic NETs and evidence of Radiological Progression (RP) according to RECIST 1.1 were identified from a NET database. Plasma CgA were measured 6 and 12 months before RP and at the event of RP. CgA was measured with the Supra-regional-Assay-Service radioimmunoassay (Hammersmith Hospital), normal value <60 pmol/L. The tumours were graded according to the 2010 WHO classification, as G1 (Ki67 <2%), G2 (Ki67: 2-20%), G3 (Ki67 >20%). Results 152 patients were evaluable including 91 midgut NET and 61 pancreatic NETs (PNETs). Of these, 56 were G1 NETs, 65 G2, 10 G3, 21 of unknown histology. 95.4% of the patients had liver metastases, whereas bone and lung metastases were present in a smaller proportion of patients (27.6 and 9.9%, respectively). PTH-093

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A regional EUS service using a collaborative network

Cited by 5 publications

References 7 publications

Curriculum for diagnostic endoscopic ultrasound training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

Curriculum for diagnostic endoscopic ultrasound training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

Highlights from this issue

PTH-094 Benefit Of Real Time Cytological Examination In Eus Guided Biopsy Of Suspected Pancreatic Malignancy

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