Article Text
Abstract
Introduction Endoscopic therapy for the management of patients with Barrett’s oesophagus (BE) neoplasia has significantly developed in the past decade; however, significant variation in clinical practice exists. The aim of this project was to develop expert physician-lead quality indicators (QIs) for Barrett’s endoscopic therapy.
Methods The RAND/UCLA Appropriateness Method was used to combine the best available scientific evidence with the collective judgement of experts to develop quality indicators for Barrett’s endotherapy in four subgroups: pre-endoscopy, intraprocedure (resection and ablation) and postendoscopy. International experts, including gastroenterologists, surgeons, BE pathologist, clinical nurse specialist and patient representative, participated in a three-round process to develop 15 QIs that fulfilled the RAND/UCLA definition of appropriateness.
Results 17 experts participated in round 1 and 20 in round 2. Of the 24 proposed QIs in round 1, 20 were ranked as appropriate (put through to round 2) and 4 as uncertain (discarded). At the end of round 2, a final list of 15 QIs were scored as appropriate.
Conclusions This UK national consensus project has successfully developed QIs for patients undergoing Barrett’s endotherapy. These QIs can be used by service providers to ensure that all patients with BE neoplasia receive uniform and high-quality care.
- Barrett’s Oesophagus
- endoscopy
- Endoscopic Mucosal Resection (EMR)
- Endoscopic Submucosal Dissection (ESD)
- Radio Frequency Ablation (RFA)
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Footnotes
Presented at This study was previously presented as an abstract at UEGW 2018.
Contributors DA is the first author, and has written and submitted the manuscript, and was directly involved with the planning, analysis, data search and critique of this paper. KR, SW, IDP, NJT, MJ, MB, PrB, AJM, RW, PhB, HLS, NR, JD, CG, JM, IM, MdP, AMV, ST, CM, ME, SS, DG, SA, OP, PS and LBL were directly involved with the planning and critique of this paper and provided intellectual input to this paper. PaB significantly contributed to the statistical analysis and critique of this paper. RH was directly involved in the planning, analysis, data search and critique of this paper, and is the senior author. All authors contributed to the refinement of the paper and approved the final manuscript.
Funding This project received funding from the BSG to cover travel expenses endured by the investigators in order to attend the face-to-face meeting in London for round 2 voting.
Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information.