PT - JOURNAL ARTICLE AU - Thrumurthy, Sri AU - Htet, Hein Myat Thu AU - Denesh, Deepa AU - Kandiah, Kesavan AU - Mohammed, Noor AU - Gulati, Shraddha AU - Emmanuel, Andrew AU - Bhandari, Pradeep AU - Haji, Amyn AU - Hayee, Bu'Hussain TI - High burden of polyp mischaracterisation in tertiary centre referrals for endoscopic resection may be alleviated by telestration AID - 10.1136/flgastro-2022-102161 DP - 2023 Jan 01 TA - Frontline Gastroenterology PG - 32--37 VI - 14 IP - 1 4099 - http://fg.bmj.com/content/14/1/32.short 4100 - http://fg.bmj.com/content/14/1/32.full SO - Frontline Gastroenterol2023 Jan 01; 14 AB - Objective Endoscopic resection (ER) often involves referral to tertiary centres with high volume practices. Lesions can be subject to prior manipulation and mischaracterisation of features required for accurate planning, leading to prolonged or cancelled procedures. As potential solutions, repeating diagnostic procedures is burdensome for services and patients, while even enriched written reports and still images provide insufficient information to plan ER. This project sought to determine the frequency and implications of polyp mischaracterisation and whether the use of telestration might prevent it.Design/method A retrospective data analysis of ER referrals to four tertiary centres was conducted for the period July–December 2019. Prospective telestration with a novel digital platform was then performed between centres to achieve consensus on polyp features and ER planning.Results 163 lesions (163 patients; mean age 67.9±12.2 y; F=62) referred from regional hospitals, were included. Lesion site was mismatched in 11 (6.7%). Size was not mentioned in the referral in 27/163 (16.6%) and incorrect in 81/136 (51.5%), more commonly underestimated by the referring centre (<0.0001), by a mean factor of 1.85±0.79. Incurred procedure time (in units of 20 min) was significantly greater than that allocated (p=0.0085). For 10 cases discussed prospectively, rapid consensus on lesion features was achieved, with agreement between experts on time required for ER.Conclusions Polyp mischaracterisation is a frequent feature of ER referrals, but could be corrected by the use of telestration between centres. Our study involved expert-to-expert consensus, so extending to ‘real-world’ referring centres would offer additional learning for a digital pathway.Data sharing not applicable as no data sets generated and/or analysed for this study.