Validation of the size morphology site access score in endoscopic mucosal resection of large polyps in a district general hospital

Ac, Currie; H, Merriman; S, Nadia shah Gilani; Mackenzie, Paul; Mr, McFall; Mk, Baig

doi:10.1308/rcsann.2019.0068

Cited by 7 publications

(3 citation statements)

References 20 publications

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“…Application of SMSA divides complexity of polypectomy into four levels: level 1 (4–5), level 2 (6–8), level 3 (9–12) and level 4 (>12). Defining the difficulty level of polypectomy aids therapeutic decision making, correlates with adverse events and can avoid unnecessary repeat procedures 42 43. For larger polyps, the SMSA level can also determine the appropriate endoscopist and time slot allocation for a future polypectomy.…”

Section: Recommendation Statementsmentioning

confidence: 99%

JAG consensus statements for training and certification in flexible sigmoidoscopy

Siau

Pelitari

Green

et al. 2023

Frontline Gastroenterol

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IntroductionJoint Advisory Group (JAG) certification in endoscopy is awarded when trainees attain minimum competency standards for independent practice. A national evidence-based review was undertaken to update standards for training and certification in flexible sigmoidoscopy (FS).MethodsA modified Delphi process was conducted between 2019 and 2020 with multisociety representation from experts and trainees. Following literature review and Grading of Recommendations, Assessment, Development and Evaluations appraisal, recommendation statements on FS training and certification were formulated and subjected to anonymous voting to obtain consensus. Accepted statements were peer-reviewed by national stakeholders for incorporation into the JAG FS certification pathway.ResultsIn total, 41 recommendation statements were generated under the domains of: definition of competence (13), acquisition of competence (17), assessment of competence (7) and postcertification support (4). The consensus process led to revised criteria for colonoscopy certification, comprising: (A) achieving key performance indicators defined within British Society of Gastroenterology standards (ie, rectal retroversion >90%, polyp retrieval rate >90%, patient comfort <10% with moderate-severe discomfort); (B) minimum procedure count ≥175; (C) performing 15+ procedures over the preceding 3 months; (D) attendance of the JAG Basic Skills in Lower gastrointestinal Endoscopy course; (E) satisfying requirements for formative direct observation of procedural skill (DOPS) and direct observation of polypectomy skill (SMSA level 1); (F) evidence of reflective practice as documented on the JAG Endoscopy Training System reflection tool and (G) successful performance in summative DOPS.ConclusionThe UK standards for training and certification in FS have been updated to support training, uphold standards in FS and polypectomy, and provide support to the newly independent practitioner.

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Section: Recommendation Statementsmentioning

confidence: 99%

JAG consensus statements for training and certification in flexible sigmoidoscopy

Siau

Pelitari

Green

et al. 2023

Frontline Gastroenterol

View full text Add to dashboard Cite

show abstract

“…Application of SMSA divides complexity of polypectomy into four levels: level 1 (4–5), level 2 (6–8), level 3 (9–12), and level 4 (>12). Defining the difficulty level of polypectomy aids therapeutic decision-making, correlates with adverse events and can avoid unnecessary repeat procedures 29 30. For larger polyps, the SMSA level can determine the appropriate colonoscopist and time slot allocation for a future polypectomy.…”

Section: Recommendation Statementsmentioning

confidence: 99%

JAG consensus statements for training and certification in colonoscopy

Siau

Pelitari

Green

et al. 2023

Frontline Gastroenterol

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IntroductionIn the UK, endoscopy certification is awarded when trainees attain minimum competency standards for independent practice. A national evidence-based review was undertaken to update and develop standards and recommendations for colonoscopy training and certification.MethodsUnder the oversight of the Joint Advisory Group (JAG), a modified Delphi process was conducted between 2019 and 2020 with multisociety expert representation. Following literature review and Grading of Recommendations, Assessment, Development and Evaluations appraisal, recommendation statements on colonoscopy training and certification were formulated and subjected to anonymous voting to obtain consensus. Accepted statements were peer reviewed by JAG and relevant stakeholders for incorporation into the updated colonoscopy certification pathway.ResultsIn total, 45 recommendation statements were generated under the domains of: definition of competence (13), acquisition of competence (20), assessment of competence (8) and postcertification support (4). The consensus process led to revised criteria for colonoscopy certification, comprising: (1) achieving key performance indicators defined within British Society of Gastroenterology standards (ie, unassisted caecal intubation rate >90%, rectal retroversion >90%, polyp detection rate >15%+, polyp retrieval rate >90%, patient comfort <10% with moderate–severe discomfort); (2) minimum procedure count 280+; (3) performing 15+ procedures over the preceding 3 months; (4) attendance of the JAG Basic Skills in Colonoscopy course; (5) terminal ileal intubation rates of 60%+ in inflammatory bowel disease; (6) satisfying requirements for formative direct observation of procedure skills (DOPS) and direct observation of polypectomy skills (Size, Morphology, Site, Access (SMSA) level 2); (7) evidence of reflective practice as documented on the JAG Endoscopy Training System reflection tool; (8) successful performance in summative DOPS.ConclusionThe UK standards for training and certification in colonoscopy have been updated, culminating in a single-stage certification process with emphasis on polypectomy competency (SMSA Level 2+). These standards are intended to support training, improve standards of colonoscopy and polypectomy, and provide support to the newly independent practitioner.

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“…There are two scores that deal with technical difficulty or prediction of recurrence after endoscopic mucosal resection (EMR) of colorectal polyps [186][187][188][189][190][191][192]. The first score, called the SMSA score, is based on the variables size (S), morphology (M), site (S), and access (A), and has been studied by various groups, who have demonstrated the link between the SMSA score and the outcome of colonic EMR [187][188][189][190]. The second score, the Sydney EMR Recurrence Tool (SERT), has been shown to predict post-EMR recurrence [191].…”

Section: Hepatopancreaticobiliary Endoscopy -Ercpmentioning

confidence: 99%

Revising the European Society of Gastrointestinal Endoscopy (ESGE) research priorities: a research progress update

et al. 2021

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Background One of the aims of the European Society of Gastrointestinal Endoscopy (ESGE) is to encourage high quality endoscopic research at a European level. In 2016, the ESGE research committee published a set of research priorities. As endoscopic research is flourishing, we aimed to review the literature and determine whether endoscopic research over the last 4 years had managed to address any of our previously published priorities. Methods As the previously published priorities were grouped under seven different domains, a working party with at least two European experts was created for each domain to review all the priorities under that domain. A structured review form was developed to standardize the review process. The group conducted an extensive literature search relevant to each of the priorities and then graded the priorities into three categories: (1) no longer a priority (well-designed trial, incorporated in national/international guidelines or adopted in routine clinical practice); (2) remains a priority (i. e. the above criterion was not met); (3) redefine the existing priority (i. e. the priority was too vague with the research question not clearly defined). Results The previous ESGE research priorities document published in 2016 had 26 research priorities under seven domains. Our review of these priorities has resulted in seven priorities being removed from the list, one priority being partially removed, another seven being redefined to make them more precise, with eleven priorities remaining unchanged. This is a reflection of a rapid surge in endoscopic research, resulting in 27 % of research questions having already been answered and another 27 % requiring redefinition. Conclusions Our extensive review process has led to the removal of seven research priorities from the previous (2016) list, leaving 19 research priorities that have been redefined to make them more precise and relevant for researchers and funding bodies to target.

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Validation of the size morphology site access score in endoscopic mucosal resection of large polyps in a district general hospital

Cited by 7 publications

References 20 publications

JAG consensus statements for training and certification in flexible sigmoidoscopy

JAG consensus statements for training and certification in flexible sigmoidoscopy

JAG consensus statements for training and certification in colonoscopy

Revising the European Society of Gastrointestinal Endoscopy (ESGE) research priorities: a research progress update

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