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Triaging advanced GI endoscopy procedures during the COVID-19 pandemic: consensus recommendations using the Delphi method

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 4...

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Autores principales: Sawhney, Mandeep S., Bilal, Mohammad, Pohl, Heiko, Kushnir, Vladimir M., Khashab, Mouen A., Schulman, Allison R., Berzin, Tyler M., Chahal, Prabhleen, Muthusamy, V. Raman, Varadarajulu, Shyam, Banerjee, Subhas, Ginsberg, Gregory G., Raju, Gottumukkala S., Feuerstein, Joseph D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: by the American Society for Gastrointestinal Endoscopy 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7229945/
https://www.ncbi.nlm.nih.gov/pubmed/32425235
http://dx.doi.org/10.1016/j.gie.2020.05.014
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author Sawhney, Mandeep S.
Bilal, Mohammad
Pohl, Heiko
Kushnir, Vladimir M.
Khashab, Mouen A.
Schulman, Allison R.
Berzin, Tyler M.
Chahal, Prabhleen
Muthusamy, V. Raman
Varadarajulu, Shyam
Banerjee, Subhas
Ginsberg, Gregory G.
Raju, Gottumukkala S.
Feuerstein, Joseph D.
author_facet Sawhney, Mandeep S.
Bilal, Mohammad
Pohl, Heiko
Kushnir, Vladimir M.
Khashab, Mouen A.
Schulman, Allison R.
Berzin, Tyler M.
Chahal, Prabhleen
Muthusamy, V. Raman
Varadarajulu, Shyam
Banerjee, Subhas
Ginsberg, Gregory G.
Raju, Gottumukkala S.
Feuerstein, Joseph D.
author_sort Sawhney, Mandeep S.
collection PubMed
description 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.
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spelling pubmed-72299452020-05-18 Triaging advanced GI endoscopy procedures during the COVID-19 pandemic: consensus recommendations using the Delphi method Sawhney, Mandeep S. Bilal, Mohammad Pohl, Heiko Kushnir, Vladimir M. Khashab, Mouen A. Schulman, Allison R. Berzin, Tyler M. Chahal, Prabhleen Muthusamy, V. Raman Varadarajulu, Shyam Banerjee, Subhas Ginsberg, Gregory G. Raju, Gottumukkala S. Feuerstein, Joseph D. Gastrointest Endosc Article 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. by the American Society for Gastrointestinal Endoscopy 2020-09 2020-05-16 /pmc/articles/PMC7229945/ /pubmed/32425235 http://dx.doi.org/10.1016/j.gie.2020.05.014 Text en © 2020 by the American Society for Gastrointestinal Endoscopy. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Article
Sawhney, Mandeep S.
Bilal, Mohammad
Pohl, Heiko
Kushnir, Vladimir M.
Khashab, Mouen A.
Schulman, Allison R.
Berzin, Tyler M.
Chahal, Prabhleen
Muthusamy, V. Raman
Varadarajulu, Shyam
Banerjee, Subhas
Ginsberg, Gregory G.
Raju, Gottumukkala S.
Feuerstein, Joseph D.
Triaging advanced GI endoscopy procedures during the COVID-19 pandemic: consensus recommendations using the Delphi method
title Triaging advanced GI endoscopy procedures during the COVID-19 pandemic: consensus recommendations using the Delphi method
title_full Triaging advanced GI endoscopy procedures during the COVID-19 pandemic: consensus recommendations using the Delphi method
title_fullStr Triaging advanced GI endoscopy procedures during the COVID-19 pandemic: consensus recommendations using the Delphi method
title_full_unstemmed Triaging advanced GI endoscopy procedures during the COVID-19 pandemic: consensus recommendations using the Delphi method
title_short Triaging advanced GI endoscopy procedures during the COVID-19 pandemic: consensus recommendations using the Delphi method
title_sort triaging advanced gi endoscopy procedures during the covid-19 pandemic: consensus recommendations using the delphi method
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7229945/
https://www.ncbi.nlm.nih.gov/pubmed/32425235
http://dx.doi.org/10.1016/j.gie.2020.05.014
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