What can you get involved in now?

OESOPHAGEAL DILATATION FOR BENIGN STRICTURES - our first collaboration, with YaHGuT research group

As our first collaboration with another trainee-led research group - Yorkshire And Humber Gastroenterology aUdit and research Trainee network (YaHGuT) - we will be looking to investigate effectiveness, adherence to guidelines and risk factors for failure in patients undergoing endoscopic dilatation for benign oesophageal strictures (BOS).

In the context of increased prevalence of GORD and other aetiologies, an increase in detection and need for treatment of BOS is likely. The most commonly employed therapeutic strategy for symptomatic BOS is endoscopic dilatation (ED). A number of guidelines (including the BSG's 'UK guidelines on oesophageal dilatation in clinical practice' have been published in recent years) but adherence to these, and success of this, has never been investigated in a multi-centre cohort.

Alongside assessing adherence to guidelines, this collaboration aims to explore the differential efficacy of ED in the context of the varying aetiologies, establish frequency of adverse events from ED, and finally to corroborate and confirm risk factors for refractory and recurrent BOS development.

Data collection commenced January 2024

- sites still being recruited, however so contact us to get involved!

CURRENT & ONGOING PROJECTS

DUODENOSCOPE-ASSOCIATED INFECTION rate post-ERCP: A national multi-centre study

We will be investigating the incidence of infection following endoscopic retrograde cholangiopancreatography (ERCP) with reusable duodenoscopes.

In recent years, there has been a greater awareness of the risk of endoscopy associated infections, resulting in increased interest from commercial companies to adopt single-use endoscopes in clinical practice; however, current data surrounding duodenoscope associated infection (DAI) with reusable duodenoscopes are limited and heterogenous.

Before considering such a radical change to ERCP practice, robust evidence is required of the infection risk to patients from reusable duodenoscopes . Thus, the aim of this project is, through a national retrospective multicentre audit design, to identify the DAI rate for reusable duodenoscopes in ERCP, with particular attention to unplanned/extended admission or extended length of stays that result.

Undergoing write-up - watch this space!

SUSTAINABILITY PROJECT: Achieving a greener NHS

We will be assessing the effect that moving to mainly virtual clinic appointments has had on carbon emissions.

Virtual consultations have proved feasible during the COVID era, and whilst we know that mileage travelled by car/public transport has reduced, there is a lack of data on the impact remote consultations have had on carbon emissions.

The aim of our project is to assess the carbon emissions of patients attending gastroenterology outpatient services before (mainly face to face) and during the pandemic (mainly virtual) and any adverse outcomes resulting from virtual consultations. The data collected will then be used to quantify the reduction in carbon emissions achieved by adapting to remote clinics.

Recently submitted for publication - updates to follow soon!

Successful projects from the pasT

Poster presentations

Quality of care in adult IBD patients transferring between healthcare providers: multi-centre audit

GLINT Research Network

Thanks to the incredible efforts of our delegates across 16 hospitals in London we successfully submitted the project at the BSG annual conference in Glasgow, June 2019, for poster presentation.

One of our delegates, Penny Sellers, was picked at random from a group of enthusiastic volunteers to present our poster at the conference. A great success for all involved - thank you and well done!

Use of a standardised ulcerative colitis (UC) reporting proforma is associated with more optimal endoscopic reporting

GLINT Research Network, Rawen Kader, Paul Middleton, Omer Ahmad, Robin J Dart, Joshua McGuire, Mark A Samaan, Gregory M Sebepos-Rogers, Jonathan P Segal, Eather Shakweh

Our second project was accepted for presentation at ECCO, February 2020. Again, this effort required the complex coordination of results across multiple sites in London -seven in total this time - and lead to 899 data points. The results provide an interesting and important insight in to endoscopic reporting and how to possibly improve standardisation.

Transient elastography is underutilised in London hospitals and results in unnecessary endoscopic screening for oesophageal varices: a multi-site audit of practice

Michael Colwill, Lalana Songra, Metin Yalcin, Khizar Rafique, Rajan Patel, Charlotte Skinner, Saniath Akbar, Luke Lake, Andra Caracostea, Jennifer Clough, Rawan Kader, Sean Carlson, Eather Shakweh, Mohamed El-Sayed, Samuel Tribich, Ava Zamani, Emma Michael, Maria Baysham, Khin Han, Alexandra Chang, Alexander Cole, Louise China, James Maurice

Michael Colwill presented our multi-site audit on the use of the Baveno VI guidelines in hospitals across London at BASL's annual virtual meeting in September 2020. This work is more pertinent now than ever given the current strain on outpatient endoscopy services due to the COVID pandemic.

12 hospitals were involved with 828 endoscopies reviewed over a 6 month period. Of the patients who had had a recent transient elastography and gone on to have a screening OGD, over 80% did not meet the criteria for this: a potential saving of £48,000 - although 6.34% of those outside the Baveno criteria did go on to have significant varices.

Full papers

Quality of care in adult IBD patients transferring between healthcare providers: multi-centre audit

GLINT Research Network, Omer F Ahmad, Homira Ayubi, Jennie Clough, Robin Dart, Radha Gadhok, Samuel Pannick, Gareth Parkes, Polychronis Pavlidis, Jonathan Segal, Penelope Sellers

Following the success and importance of the findings in the initial poster presented at the 2019 Annual BSG Conference, we decided to expand our findings in to a complete paper and are proud to have had it successfully published in Frontline Gastroenterology, completing an impressive inaugural year for our network.

Full article here

Implementation of an intervention bundle leads to quality improvement in ulcerative colitis endoscopy reporting (GastroHep 2020)

Rawen Kader, Robin J. Dart, Gregory Sebepos-Rogers, Eathar Shakweh, Paul Middleton, Joshua McGuire, Polychronis Pavlidis, Omer F. Ahmad, GLINT Research Network, Jonathan Segal, Mark A. Samaan

https://onlinelibrary.wiley.com/doi/abs/10.1002/ygh2.427

Unlocking the benefits of the Baveno VI guidance when screening for varices: an audit of clinical practice across London (Future Healthcare Journal 2022)

Future Healthcare Journal 2022 Vol 9, No 1: 1–4

Michael Colwill, Luke Lake, Ahmed El-Sayed, Jonathan King, Rawen Kader, Eathar Shakweh, Andra Caracostea, Louise China and James Maurice

https://www.rcpjournals.org/content/futurehosp/early/2022/01/18/fhj.2021-0130