Photodocumentation in colonoscopy: the need to do better?

Winning the Colonoscopy Revaluation Delay

GI endoscopic reprocessing: maintaining public confidence in the face of decreasing reimbursements

The lay public frequently access and rely on online information as a source of their medical knowledge. Many medical societies are unaware of national patient education material guidelines and subsequently fail to meet them. The goal of the present study was to evaluate the readability of patient education materials within the medical field of gastroenterology. Two hundred fourteen articles pertaining to patient education materials were evaluated with ten well-established readability scales. The articles were available on the websites for the American College of Gastroenterology (ACG), the American Gastroenterological Association (AGA), the American Society of Gastrointestinal Endoscopy (ASGE), the British Society of Gastroenterology (BSG), and the NIH section National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). One-way analysis of variance (ANOVA) and Tukey's honest significant difference (HSD) post hoc analysis were conducted to determine any differences in level of readability between websites. The 214 articles were written at an 11.8±2.1 grade level with a range of 8.0 to 16.0 grade level. A one-way ANOVA and Tukey's HSD post hoc analysis determined the ACG was written at a significantly (p<0.05) more difficult level when compared to the AGA, the BSG, and the NIDDK websites. No differences were noted when comparing the ASGE website. None of the patient education materials were written at a level that met national guidelines. If the materials are redrafted, the general American public will likely have a greater understanding of the gastroenterology content.

The Road Ahead

Quality of care is the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge (1). The American Society for Gastrointestinal Endoscopy (ASGE), the American College of Gastroenterology (ACG), and the American Gastroenterological Association (AGA) have continually promoted the ideal that all patients have access to high-quality GI endoscopy services. A high-quality endoscopy is an examination in which patients receive an indicated procedure, correct and relevant diagnoses are recognized or excluded, any therapy provided is appropriate, and all steps that minimize risk have been taken.

Faigel, Douglas O. M.D., ASGE Co-Chair.; Pike, Irving M. M.D., ACG Co-Chair.; Baron, Todd H. M.D.; Chak, Amitabh M.D.; Cohen, Jonathan M.D.; Deal, Stephen E. M.D.; Hoffman, Brenda M.D.; Jacobson, Brian C. M.D., M.P.H.; Mergener, Klaus M.D., Ph.D.; Petersen, Bret T. M.D.; Petrini, John L. M.D.; Rex, Douglas K. M.D.; Safdi, Michael A. M.D. Author Information

GI multisociety strategic plan on environmental sustainability.

The Gastroenterology Core Curriculum, Third Edition

Guidelines on genetic evaluation and management of Lynch syndrome: A consensus statement by the U.S. Multi-Society Task Force on Colorectal Cancer

Multisociety guideline on reprocessing flexible GI endoscopes: 2016 update

Avoidance of PEG 3350 in patients with CHF, cirrhosis, and chronic kidney disease

ABSTRACTObjectivesThe risk of colitis‐associated cancer increases with disease duration in ulcerative colitis (UC), yet surveillance colonoscopy protocols generally stratify risk uniformly for patients with disease lasting over 8 years. This study evaluated whether shorter surveillance intervals might enhance lesion detection rates in patients with extended disease duration.MethodsThis retrospective observational study analyzed patients diagnosed with UC‐associated neoplasms between 2010 and 2023. Colonoscopies before lesion detection were retrospectively reviewed, and risk stratification was applied according to four established guidelines. The recommended surveillance intervals were recalculated based on the stratified risk, and lesion detection rates were compared across increasing risk categories for specific disease duration.ResultsA total of 39 patients were included, with a median disease duration of 21 years (14–27), and a median colonoscopy interval of 1.3 years (1.1–2.2). Lesion detection rates were 72%, 59%, 44%, and 56% for American Society for Gastrointestinal Endoscopy (ASGE), American Gastroenterological Association (AGA), European Crohn's and Colitis Organisation (ECCO), and British Society of Gastroenterology (BSG) guidelines, respectively. Adjusting risk stratification upward by one rank for disease durations of ≥ 15, ≥ 20, ≥ 25, and ≥ 30 years resulted in increased detection rates: 90%, 87%, 82%, and 72% for ASGE; 85%, 82%, 74%, and 64% for AGA; 82%, 74%, 62%, and 49% for ECCO; and 82%, 79%, 72%, and 62% for BSG, respectively. The longest period with a significant difference in detection rates was observed in patients with disease durations of 20–25 years.ConclusionsFor patients with long‐standing UC, reducing surveillance intervals may improve the detection of colitis‐associated neoplasia, with a practical focus on those with 20–25 years of disease duration.

American Society for Gastrointestinal Endoscopy guideline on the diagnosis and management of GERD: summary and recommendations.

Competence in gastrointestinal (GI) endoscopy correlates with the number of procedures performed by the endoscopist. For each GI endoscopic procedure, the American Society for Gastrointestinal Endoscopy (ASGE) guidelines recommend minimum numbers needed to assess competence. We conducted an anonymous mail survey to determine whether GI endoscopy centers in the United States follow ASGE or other guidelines for granting and renewing endoscopic privileges. Completed surveys were received from 479 respondents in 46 states, Puerto Rico, and the District of Columbia. Most respondents were either the physician director (24%) or nurse manager (57%) of the endoscopy center. Most centers have more than 5 endoscopists (62%), and gastroenterologists performed procedures in the majority of the centers (89%). For initial endoscopic credentialing, few centers require a minimum number of procedures and only 10% meet ASGE criteria. To maintain credentials, less than one third require a minimum number and only 2% require more than 25 procedures/year. Although three fourths report periodic review of procedures, less than 5% review them more frequently than every 6 months. Only 20% of centers had ever denied endoscopic privileges (poor skills [80%], no references [27%], poor communication [7%], and excess complications [6%]) for which half faced litigation. Most GI endoscopy centers responding to this survey have no minimum standards for determining endoscopic competence and may credential GI endoscopists with suboptimal training. Only 10% adhere to ASGE guidelines. Moreover, there is lack of uniformity to application of these guidelines, and few centers use resulting data to deny or renew credentials. To guarantee high-quality endoscopic practice, more stringent, universal credentialing standards are required.

ASGE guideline on screening for pancreatic cancer in individuals with genetic susceptibility: summary and recommendations