Triaging advanced GI endoscopy procedures during the COVID-19 pandemic: consensus recommendations using the Delphi method - 21/08/20
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Abstract |
Background and Aims |
There is a lack of consensus on which GI endoscopic procedures should be performed during the COVID-19 pandemic, and which procedures could be safely deferred without having a significant impact on outcomes.
Methods |
We selected a panel of 14 expert endoscopists. We identified 41 common indications for advanced endoscopic procedures from the ASGE Appropriate Use of GI Endoscopy guidelines. Using a modified Delphi method, we first achieved consensus on the patient-important outcome for each procedural indication. Panelists prioritized consensus patient-important outcome when categorizing each indication into one of the following 3 procedural time periods: (1) time-sensitive emergent (schedule within 1 week), (2) time-sensitive urgent (schedule within 1 to 8 weeks), and (3) non-time sensitive (defer for >8 weeks and then reassess the timing). Three anonymous rounds of voting were allowed before attempts at consensus were abandoned.
Results |
All 14 invited experts agreed to participate in the study. The prespecified consensus threshold of 51% was achieved for assigning patient-important outcome(s) to each advanced endoscopy indication. The prespecified consensus threshold of 66.7% was achieved for 40 of 41 advanced endoscopy indications in stratifying them into 1 of 3 procedural time periods. For 12 of 41 indications, 100% consensus was achieved; for 20 of 41 indications, 75% to 99% consensus was achieved.
Conclusions |
By using a Modified Delphi method that prioritized patient-important outcomes, we developed consensus recommendations on procedural timing for common indications for advanced endoscopy. These recommendations and the structured decision framework provided by our study can inform decision making as endoscopy services are reopened.
Le texte complet de cet article est disponible en PDF.Abbreviations : AGA, ASGE
Plan
| If you would like to chat with an author of this article, you may contact Dr Sawhney at msawhney@bidmc.harvard.edu. |
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| DISCLOSURE: Dr Khashab is a consultant for Boston Scientific, Olympus and Medtronic. Dr Schulman is a consultant for Apollo Endosurgery, Boston Scientific, Microtech, and receives research funding from GI Dynamics. Dr Berzin is a consultant for Boston Scientific and Medtronic. Dr Muthusamy has received research support from Medtronic and Boston Scientific, is a consultant for Medtronic, Boston Scientific, Interpace Diagnostics, Medivators, a stockholder in Capsovision, and receives honoraria from Torax Medical/Ethicon; Dr Pohl received research grants from Steris and Cosmo Pharmaceuticals. All other authors disclosed no financial relationships. |
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| See CME section; p. 754. |
Vol 92 - N° 3
P. 535-542 - septembre 2020 Retour au numéro
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