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Knowledge and attitudes towards the use of histological assessments in ulcerative colitis by gastroenterologists vs pathologists

BACKGROUND: Histological remission is increasingly accepted as a treatment endpoint in the management of ulcerative colitis (UC). However, the knowledge of histology guidelines and the attitudes towards their use in clinical practice by gastroenterologists and pathologists is unknown. AIM: To evalua...

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Autores principales: Pudipeddi, Aviv, Fung, Caroline, Christensen, Britt, Bryant, Robert V, Subramaniam, Kavitha, Chetwood, John, Paramsothy, Sudarshan, Leong, Rupert W
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9846936/
https://www.ncbi.nlm.nih.gov/pubmed/36687119
http://dx.doi.org/10.3748/wjg.v29.i2.378
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author Pudipeddi, Aviv
Fung, Caroline
Christensen, Britt
Bryant, Robert V
Subramaniam, Kavitha
Chetwood, John
Paramsothy, Sudarshan
Leong, Rupert W
author_facet Pudipeddi, Aviv
Fung, Caroline
Christensen, Britt
Bryant, Robert V
Subramaniam, Kavitha
Chetwood, John
Paramsothy, Sudarshan
Leong, Rupert W
author_sort Pudipeddi, Aviv
collection PubMed
description BACKGROUND: Histological remission is increasingly accepted as a treatment endpoint in the management of ulcerative colitis (UC). However, the knowledge of histology guidelines and the attitudes towards their use in clinical practice by gastroenterologists and pathologists is unknown. AIM: To evaluate the knowledge of histology guidelines and attitudes towards the use of histology in UC by gastroenterologists and pathologists. METHODS: A prospective, cross-sectional nationwide survey of gastroenterologists and pathologists who analyse UC specimens was conducted. The survey consisted of 34 questions to assess gastroenterologists’ and pathologists’ knowledge (score out of 19) and attitudes towards histological assessment in UC. Survey questions were formulated using the European Crohn’s and Colitis position paper on histopathology and the British Society of Gastroenterology biopsy reporting guidelines. It included knowledge of histological assessment of disease activity and dysplasia, knowledge of histological scoring systems for ulcerative colitis, uptake of histology scoring systems in routine practice, attitudes towards the role of histological activity, and the use of histological activity in clinical scenarios. RESULTS: Of 89 responders (77 gastroenterologists, 12 pathologists), there was almost universal acceptance that histological assessment should form part of UC evaluation [95% gastroenterologists, 92% pathologists]. However, gastroenterologists reported that 92% of their pathologists do not use a histological scoring system. Utilisation of a formal histological scoring system was preferred by 77% of gastroenterologists and 58% of pathologists. Both groups lacked awareness of the Geboes Score, Nancy Index and Robarts Histopathological Index scoring systems with 91%, 87%, and 92% of gastroenterologists respectively; and 83%, 83%, and 92% pathologists respectively, being uncertain of scoring systems’ remission definitions. Histology knowledge score was not significantly different between gastroenterologists and pathologists [9/19 (IQR: 8-11) vs 8/19 (IQR: 7-10), P = 0.54]. Higher knowledge scores were predicted by hospital attending gastroenterologists (P = 0.004), participation in inflammatory bowel disease (IBD) multidisciplinary teams (P = 0.009), and self-declared IBD sub-specialist (P = 0.03). CONCLUSION: Histological remission is a recognised target for both gastroenterologists and pathologists. Despite this, knowledge of histological scoring systems and their utilisation is poor.
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spelling pubmed-98469362023-01-19 Knowledge and attitudes towards the use of histological assessments in ulcerative colitis by gastroenterologists vs pathologists Pudipeddi, Aviv Fung, Caroline Christensen, Britt Bryant, Robert V Subramaniam, Kavitha Chetwood, John Paramsothy, Sudarshan Leong, Rupert W World J Gastroenterol Observational Study BACKGROUND: Histological remission is increasingly accepted as a treatment endpoint in the management of ulcerative colitis (UC). However, the knowledge of histology guidelines and the attitudes towards their use in clinical practice by gastroenterologists and pathologists is unknown. AIM: To evaluate the knowledge of histology guidelines and attitudes towards the use of histology in UC by gastroenterologists and pathologists. METHODS: A prospective, cross-sectional nationwide survey of gastroenterologists and pathologists who analyse UC specimens was conducted. The survey consisted of 34 questions to assess gastroenterologists’ and pathologists’ knowledge (score out of 19) and attitudes towards histological assessment in UC. Survey questions were formulated using the European Crohn’s and Colitis position paper on histopathology and the British Society of Gastroenterology biopsy reporting guidelines. It included knowledge of histological assessment of disease activity and dysplasia, knowledge of histological scoring systems for ulcerative colitis, uptake of histology scoring systems in routine practice, attitudes towards the role of histological activity, and the use of histological activity in clinical scenarios. RESULTS: Of 89 responders (77 gastroenterologists, 12 pathologists), there was almost universal acceptance that histological assessment should form part of UC evaluation [95% gastroenterologists, 92% pathologists]. However, gastroenterologists reported that 92% of their pathologists do not use a histological scoring system. Utilisation of a formal histological scoring system was preferred by 77% of gastroenterologists and 58% of pathologists. Both groups lacked awareness of the Geboes Score, Nancy Index and Robarts Histopathological Index scoring systems with 91%, 87%, and 92% of gastroenterologists respectively; and 83%, 83%, and 92% pathologists respectively, being uncertain of scoring systems’ remission definitions. Histology knowledge score was not significantly different between gastroenterologists and pathologists [9/19 (IQR: 8-11) vs 8/19 (IQR: 7-10), P = 0.54]. Higher knowledge scores were predicted by hospital attending gastroenterologists (P = 0.004), participation in inflammatory bowel disease (IBD) multidisciplinary teams (P = 0.009), and self-declared IBD sub-specialist (P = 0.03). CONCLUSION: Histological remission is a recognised target for both gastroenterologists and pathologists. Despite this, knowledge of histological scoring systems and their utilisation is poor. Baishideng Publishing Group Inc 2023-01-14 2023-01-14 /pmc/articles/PMC9846936/ /pubmed/36687119 http://dx.doi.org/10.3748/wjg.v29.i2.378 Text en ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
spellingShingle Observational Study
Pudipeddi, Aviv
Fung, Caroline
Christensen, Britt
Bryant, Robert V
Subramaniam, Kavitha
Chetwood, John
Paramsothy, Sudarshan
Leong, Rupert W
Knowledge and attitudes towards the use of histological assessments in ulcerative colitis by gastroenterologists vs pathologists
title Knowledge and attitudes towards the use of histological assessments in ulcerative colitis by gastroenterologists vs pathologists
title_full Knowledge and attitudes towards the use of histological assessments in ulcerative colitis by gastroenterologists vs pathologists
title_fullStr Knowledge and attitudes towards the use of histological assessments in ulcerative colitis by gastroenterologists vs pathologists
title_full_unstemmed Knowledge and attitudes towards the use of histological assessments in ulcerative colitis by gastroenterologists vs pathologists
title_short Knowledge and attitudes towards the use of histological assessments in ulcerative colitis by gastroenterologists vs pathologists
title_sort knowledge and attitudes towards the use of histological assessments in ulcerative colitis by gastroenterologists vs pathologists
topic Observational Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9846936/
https://www.ncbi.nlm.nih.gov/pubmed/36687119
http://dx.doi.org/10.3748/wjg.v29.i2.378
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