Joint Advisory Group on Gastrointestinal Endoscopy (JAG) achieves enduring large-scale change

Valori, Roland

doi:10.1136/flgastro-2018-101115

Cited by 4 publications

(3 citation statements)

References 9 publications

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“…The risk of perforation and bleeding is well recognized and may also lead to lethal complications [53]. Thus, screening procedures have to be carried out by highly trained colonoscopists, and therefore, systematic training is important and has been shown to be effective [54,55]. It has also recently been shown from the Polish programme that even if all lesions are removed during a screening colonoscopy, there is a risk for CRC if the lesions are bigger than 20 mm, whereas if they are smaller, there is a decreased risk compared with those with no lesions [56].…”

Section: Colonoscopymentioning

confidence: 99%

Aspects of colorectal cancer screening, methods, age and gender

Hultcrantz

2020

J. Intern. Med.

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Colorectal cancer (CRC) is, besides breast, prostate, lung and skin cancers, the most common cancer worldwide and is suitable for screening. The incidence of CRC varies considerably in different parts of the world: in well-developed countries, the incidence is between 30 and 70 per 100 000 inhabitants, whereas in less-developed countries such as sub-Saharan Africa, it is 10-20/100 000 inhabitants. Women have a lower incidence of CRC, which is usually one-third of total incidence. Several studies have shown that it is possible to decrease mortality from CRC with about 20%, which is evidenced through the data from countries with screening programmes. Though the method of choice to identify blood samples in faecal matter is under debate, the most feasible way is to perform colonoscopy. Other methods include more advanced faecal analyses, testing for mutations from CRC, sigmoidoscopy, CT colonoscopy or optical colonoscopy. Colonoscopy is in most countries not available in sufficient amount and has to be carried out with great accuracy; otherwise, lesions will be missed to identify, thus leading to complications. Gender is an issue in CRC screening, as women have about 20% fewer colorectal adenomas and CRCs, but they also have more right-sided lesions, which are more difficult to detect with tests for faecal blood since they create less blood in faeces. Thus, other strategies may have to be developed for women in order for screening to have the same effect. It is essential to introduce colorectal cancer screening in all countries together with other clinical pieces of advice such as information on smoking, obesity and exercise in order to reduce one of the most dangerous cancers.

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Section: Colonoscopymentioning

confidence: 99%

Aspects of colorectal cancer screening, methods, age and gender

Hultcrantz

2020

J. Intern. Med.

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“…Our aim and desire is to achieve the same results as the English Joint Advisory Group on Gastrointestinal Endoscopy, which has strong leadership at national level, offers guidance and pro-cesses to support the endoscopy services, and is always looking for ways to improve [30] Fig. 5 Quality indicators for PEG: frequency of criteria not met according to the endoscopic report.…”

Section: Discussionmentioning

confidence: 99%

The Italian Society for Digestive Endoscopy (SIED) accreditation and quality improving project based on international standards

Spinzi

Milano

Brosolo³

et al. 2020

Endosc Int Open

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Background and study aims Accreditation of endoscopy services, using valid quality indicators, may address failures to comply with quality standards between endoscopy services. The aim of this work was to present the Italian Society for Digestive Endoscopy (SIED) accreditation model and its effectiveness. Methods A team of eight endoscopists identified quality indicators derived from international guidelines and assessed them in each center voluntarily requesting accreditation. During a 1-day site visit, two expert endoscopists, the representative of the independent and international administrative certification body and a professional nurse evaluated the endoscopy center, by direct observation of the endoscopy team and examination of the medical records Results In all centers we noted shortcomings in instrument reprocessing. In 30 of 40 centers (75 %) the information in the nursing charts was incomplete. Sampling for Helicobacter pylori had not been done in 12 of 40 centers (30 %). In six of 40 centers (15 %) the adenoma detection rate for each endoscopist had not been evaluated. Post-polypectomy intervals were inappropriate in 12 of 40 centers (30 %). We noted a statistically significant difference (P < 0.001) between the answers to the SIED checklist of indicators submitted to the inspection team for accreditation before the site visit and the situation found for colonoscopy on site. As of June 30, 2018, 18 endoscopy centers had been accredited and 10 centers had not yet being accredited because they had not completed the measures to correct points raised at the visits. Conclusions Numerous Italian endoscopy centers fail to meet important quality indicators. Our accreditation program can provide means for detecting these problems and correcting them by implementing SIED standards.

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“…Our aim was to mirror the substantial improvements in mammography screening and colonoscopy achieved by assessment, training, and monitoring (14,15); thus, we hypothesized that radiologists' diagnostic accuracy for CTC screening could be improved by individualized training with ongoing feedback. To test this hypothesis, we performed a cluster-randomized trial to determine whether 1-day individualized training in CTC reporting can improve diagnostic sensitivity of experienced radiologists for 6-mm or larger Abbreviations BCSP = Bowel Cancer Screening Programme, CRC = colorectal cancer, CTC = CT colonography, OR = odds ratio, 3D = three-dimensional,…”

Section: Ctc Testsmentioning

confidence: 99%

Colorectal Cancer: Performance and Evaluation for CT Colonography Screening— A Multicenter Cluster-randomized Controlled Trial

et al. 2022

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GASTROINTESTINAL IMAGINGS creening for early-stage colorectal cancer (CRC) and premalignant polyps reduces mortality by approximately 15% when testing feces for blood (the most common approach internationally) (1,2). In individuals who test positive for fecal blood (by guaiac or immunochemical methods), approximately 50% will have underlying colonic neoplasia (3). A positive fecal test result therefore requires further investigation, usually via colonoscopy, with CT colonography (CTC) used when colonoscopy is not possible (4). In CTC, multidetector CT scanners are used to produce twodimensional and three-dimensional (3D) images of the cleansed gas-distended colon. CTC has high sensitivity in the detection of CRC and large polyps (5), and Background: Most radiologists reporting CT colonography (CTC) do not undergo compulsory performance accreditation, potentially lowering diagnostic sensitivity. Purpose: To determine whether 1-day individualized training in CTC reporting improves diagnostic sensitivity of experienced radiologists for 6-mm or larger lesions, the durability of any improvement, and any associated factors. Materials and Methods: This prospective, multicenter cluster-randomized controlled trial was performed in National Health Service hospitals in England and Wales between April 2017 and January 2020. CTC services were cluster randomized into intervention (1-day training plus feedback) or control (no training or feedback) arms. Radiologists in the intervention arm attended a 1-day workshop focusing on CTC reporting pitfalls with individualized feedback. Radiologists in the control group received no training.Sensitivity for 6-mm or larger lesions was tested at baseline and 1, 6, and 12 months thereafter via interpretation of 10 CTC scans at each time point. The primary outcome was the mean difference in per-lesion sensitivity between arms at 1 month, analyzed using multilevel regression after adjustment for baseline sensitivity. Secondary outcomes included per-lesion sensitivity at 6-and 12-month follow-up, sensitivity for flat neoplasia, and effect of prior CTC experience.Results: A total of 69 hospitals were randomly assigned to the intervention (31 clusters, 80 radiologists) or control (38 clusters, 59 radiologists) arm. Radiologists were experienced (median, 500-999 CTC scans interpreted) and reported CTC scans routinely (median, 151-200 scans per year). One-month sensitivity improved after intervention (66.4% [659 of 992]) compared with sensitivity in the control group (42.

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Joint Advisory Group on Gastrointestinal Endoscopy (JAG) achieves enduring large-scale change

Cited by 4 publications

References 9 publications

Aspects of colorectal cancer screening, methods, age and gender

Aspects of colorectal cancer screening, methods, age and gender

The Italian Society for Digestive Endoscopy (SIED) accreditation and quality improving project based on international standards

Colorectal Cancer: Performance and Evaluation for CT Colonography Screening— A Multicenter Cluster-randomized Controlled Trial

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