Impact of the Joint Advisory Group on Gastrointestinal Endoscopy (JAG) on endoscopy services in the UK and beyond

Siau, Keith; Green, John T.; Hawkes, Neil; Broughton, Raphael; Feeney, Mark; Dunckley, Paul; Barton, J R; Stebbing, Justin; Thomas-Gibson, Siwan

doi:10.1136/flgastro-2018-100969

Cited by 72 publications

(74 citation statements)

References 119 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The gastroscopy direct observation of procedural skills (DOPS) is a formative assessment tool administered by the Joint Advisory Group on Gastrointestinal Endoscopy (JAG) [5]. The JAG oversees the governance of all gastrointestinal endoscopy training in the United Kingdom [6]. The pathway for training and certification is the same whatever the background of the trainee (gastroenterologist, surgeon, or non-medical endoscopist [NME]) and training and formative and summative assessments are performed by all trainers of all backgrounds.…”

mentioning

confidence: 99%

Direct observation of procedural skills (DOPS) assessment in diagnostic gastroscopy: nationwide evidence of validity and competency development during training

et al. 2019

Self Cite

View full text Add to dashboard Cite

Background Validated competency assessment tools and the data supporting milestone development during gastroscopy training are lacking. We aimed to assess the validity of the formative direct observation of procedural skills (DOPS) assessment tool in diagnostic gastroscopy and study competency development using DOPS. Methods This was a prospective multicentre (N = 275) analysis of formative gastroscopy DOPS assessments. Internal structure validity was tested using exploratory factor analysis and reliability estimated using generalisability theory. Item and global DOPS scores were stratified by lifetime procedure count to define learning curves, using a threshold determined from receiver operator characteristics (ROC) analysis. Multivariable binary logistic regression analysis was performed to identify independent predictors of DOPS competence. Results In total, 10086 DOPS were submitted for 987 trainees. Exploratory factor analysis identified three distinct item groupings, representing 'pre-procedure', 'technical', and 'post-procedure non-technical' skills. From generalisability analyses, sources of variance in overall DOPS scores included trainee ability (31%), assessor stringency (8%), assessor subjectivity (18%), and trainee case-to-case variation (43%). The combination of three assessments from three assessors was sufficient to achieve the reliability threshold of 0.70. On ROC analysis, a mean score of 3.9 provided optimal sensitivity and specificity for determining competency. This threshold was attained in the order of 'pre-procedure' (100-124 procedures), 'technical' (150-174 procedures), 'post-procedure non-technical' skills (200-224 procedures), and global competency (225-249 procedures). Higher lifetime procedure count, DOPS count, surgical trainees and assessors, higher trainee seniority, and lower case difficulty were significant multivariable predictors of DOPS competence. Conclusion This study establishes milestones for competency acquisition during gastroscopy training and provides validity and reliability evidence to support gastroscopy DOPS as a competency assessment tool.

show abstract

mentioning

confidence: 99%

Direct observation of procedural skills (DOPS) assessment in diagnostic gastroscopy: nationwide evidence of validity and competency development during training

et al. 2019

Self Cite

View full text Add to dashboard Cite

show abstract

“…Previous interventions in the UK, for example in colonoscopy training and certification, provided by the Joint Advisory Group on Gastrointestinal Endoscopy, have been shown to significantly improve performance and outcomes in clinical practice. 104 In addition, other care bundles such as the BSG/BASL cirrhosis bundle have led to improvements in patient-centred outcomes. 12 Many of the areas for possible improvement in AUGIB management are in the pre-endoscopy and post-endoscopy care of patients either admitted with AUGIB to hospital or who develop bleeding while hospitalised with another condition.…”

Section: Discussionmentioning

confidence: 99%

British Society of Gastroenterology (BSG)-led multisociety consensus care bundle for the early clinical management of acute upper gastrointestinal bleeding

Siau¹,

Hearnshaw

Stanley

et al. 2020

Frontline Gastroenterol

Self Cite

View full text Add to dashboard Cite

Medical care bundles improve standards of care and patient outcomes. Acute upper gastrointestinal bleeding (AUGIB) is a common medical emergency which has been consistently associated with suboptimal care. We aimed to develop a multisociety care bundle centred on the early management of AUGIB.Commissioned by the British Society of Gastroenterology (BSG), a UK multisociety task force was assembled to produce an evidence-based and consensus-based care bundle detailing key interventions to be performed within 24 hours of presentation with AUGIB. A modified Delphi process was conducted with stakeholder representation from BSG, Association of Upper Gastrointestinal Surgeons, Society for Acute Medicine and the National Blood Transfusion Service of the UK. A formal literature search was conducted and international AUGIB guidelines reviewed. Evidence was appraised using the Grading of Recommendations, Assessment, Development and Evaluation tool and statements were formulated and subjected to anonymous electronic voting to achieve consensus. Accepted statements were eligible for incorporation into the final bundle after a separate round of voting. The final version of the care bundle was reviewed by the BSG Clinical Services and Standards Committee and approved by all stakeholder groups.Consensus was reached on 19 statements; these culminated in 14 corresponding care bundle items, contained within 6 management domains: Recognition, Resuscitation, Risk assessment, Rx (Treatment), Refer and Review.A multisociety care bundle for AUGIB has been developed to facilitate timely delivery of evidence-based interventions and drive quality improvement and patient outcomes in AUGIB.

show abstract

“…The time to endoscopy (i.e., the interval from hospital admission to endoscopy) following acute upper gastrointestinal bleeding (AUGIB) has been adopted by the National Institute for Health and Clinical Excellence (NICE) [21], the Joint Advisory Group on Gastrointestinal Endoscopy (JAG) [22], and the European Society of Gastrointestinal Endoscopy (ESGE) [23] as a quality standard for both patients and endoscopy units. The NICE and ESGE recommend early endoscopy (<24 hours within admission) for all patients admitted with suspected AUGIB [21,23].…”

Section: 1mentioning

confidence: 99%

Diagnostic Value and Safety of Emergency Single-Balloon Enteroscopy for Obscure Gastrointestinal Bleeding

Yi-pin

Jiang

Chen

et al. 2019

Gastroenterology Research and Practice

View full text Add to dashboard Cite

Background. This study assesses the diagnostic performance of emergency single-balloon enteroscopy (SBE) for obscure gastrointestinal bleeding (OGIB) under general anesthesia versus conscious sedation. Study. The data of 102 OGIB in-patients from June 2015 to June 2018 were retrospectively analyzed. The diagnosis and detection rates and adverse events were calculated overall and in relation to age, gender, type of operation and anesthesia, bleeding type, different times of examination, and SBE route. All statistical analyses were performed using SPSS 24.0, and the diagnosis and detection rates were compared using the Chi-square test. Results. Among the 102 patients, 66 patients had positive findings, while 11 patients had suspected positive findings, and the diagnosis and detection rates were 64.7% and 75.5%, respectively. Ulcers (19.6%) and tumors (16.7%) were the most common causes of OGIB. There were no statistical differences in diagnosis and detection rates between the ages of ≥60 and <60 and between different genders. Patients with emergency SBE had higher diagnosis and detection rates (68.6% vs. 35.3%, P=0.023; 80.0% vs. 47.1%, P=0.016, respectively), when compared with nonemergency SBE patients. The diagnosis rate at 24 hours was higher than that at 2-7 days and one week (88.0% vs. 61.5%, P=0.030; 88.0% vs. 53.8%, P=0.007). For overt bleeding, the difference in diagnosis rates at 24 hours, 2-7 days, and one week was statistically significant (100.0% vs. 57.1%, P=0.006; 100.0% vs. 57.1%, P=0.006). For occult bleeding, the pairwise comparison revealed no statistical difference. Patients with general anesthesia had a higher detection rate, when compared to patients with conscious sedation (87.9% vs. 63.9%, P=0.004). In addition, adverse events under general anesthesia were lower, when compared to adverse events under conscious sedation (28.8% vs. 69.4%, P=0.020). There was no significant difference in adverse events at the different time points (P>0.05). Conclusion. Emergency SBE under general anesthesia achieves higher diagnosis and detection rates, and fewer adverse events under conscious sedation, when compared to nonemergency SBE, regardless of the route. For patients with overt bleeding, it is easier to find lesions by emergency SBE within 24 hours.

show abstract

Impact of the Joint Advisory Group on Gastrointestinal Endoscopy (JAG) on endoscopy services in the UK and beyond

Cited by 72 publications

References 119 publications

Direct observation of procedural skills (DOPS) assessment in diagnostic gastroscopy: nationwide evidence of validity and competency development during training

Direct observation of procedural skills (DOPS) assessment in diagnostic gastroscopy: nationwide evidence of validity and competency development during training

British Society of Gastroenterology (BSG)-led multisociety consensus care bundle for the early clinical management of acute upper gastrointestinal bleeding

Diagnostic Value and Safety of Emergency Single-Balloon Enteroscopy for Obscure Gastrointestinal Bleeding

Contact Info

Product

Resources

About