Gilles Tourlamain1, Roger Garcia-Puig2, Carolina Gutiérrez-Junquera3, Alexandra Papadopoulou4, Eleftheria Roma4, Nicolas Kalach5, Johanna Oudshoorn6, Christiane Sokollik7, Kasia Karolewska-Bochenek8, Salvatore Oliva9, Caterina Strisciuglio10, Olivia Bauraind11, Marcus Karl-Heinz Auth12, Mike Thomson13, Sebastian Otte14, Orel Rok15, Jorge Amil Dias16, Christos Tzivinikos17, Vaidotas Urbonas18, Aco Kostovski19, Noam Zevit20, Saskia Vande Velde1. 1. Ghent University Hospital, Ghent, Belgium. 2. Hospital Universitari Mútua Terrassa, Barcelona. 3. Pediatric Gastroenterology Unit, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain. 4. First Department of Pediatrics, University of Athens, Athens, Greece. 5. Saint Antoine Pediatric Clinic, Saint Vincent de Paul Hospital, Catholic University of Lille, Lille, France. 6. Department of Pediatrics, Gelre Hospital, The Netherlands. 7. Division of Pediatric Gastroenterology, Hepatology and Nutrition, University Children's Hospital, Inselspital, University of Bern, Bern, Switzerland. 8. Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland. 9. Department of Pediatrics, Pediatric Gastroenterology and Liver Unit, Sapienza- University of Rome, Rome. 10. Department of Woman, Child, General and Specialistic Surgery. University of Campania "Luigi Vanvitelli", Napoli, Italy. 11. CHC Liege, Liege, Belgium. 12. Alder Hey Children's NHS Foundation Trust and University of Liverpool, Liverpool. 13. Sheffield Children's Hospital, Sheffield, United Kingdom. 14. Dr von Hauner Children's Hospital, Ludwig-Maximilians-University of Munich, Germany. 15. University Children's Hospital Ljubljana, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia. 16. Centro Hospitalar S. João, Porto, Portugal. 17. Paediatric Gastroenterology Department Al Jalila Children's Specialty Hospital, Dubai, United Arab Emirates. 18. Clinic of Children's Disease, Vilnius, Liege, Lithuania. 19. Department for Pediatric Gastroenterohepatology, University Children's Hospital Skopje, Skopje, Macedonia. 20. Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach Tikva and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Abstract
OBJECTIVES: The aim of the study was to assess differences in the diagnosis and management of eosinophilic esophagitis (EoE) by European pediatric (PG) and adult gastroenterologists (AG), and their self-reported adherence to guidelines. METHODS: A multiple-choice questionnaire gauged the diagnostic and management strategies of gastroenterologists treating children or adults in 14 European countries and the United Arab Emirates (UAE). RESULTS: Questionnaires were completed by 465 PG and 743 AG. PG were significantly more likely to take biopsies in patients with symptoms of esophageal dysfunction (86.2% PG vs 75.4% AG, P < 0.001) and to perform endoscopic follow-up (86.3% PG vs 80.6% AG, P < 0.001). After failure of proton-pump inhibitors (PPIs), topical steroids were the preferred second-line therapy; however, PG opted more frequently for elimination diets (47.5% PG vs 13.7% AG, P < 0.001). More PG than AG indicated having read recent guidelines (89.4% PG vs 58.2% AG, P < 0.001). Geographic differences in practice were reported, with respondents from the United Kingdom, Portugal, and Spain more often adhering to recommended biopsy protocols. Physicians in the UAE, France, Lithuania, and Poland tended to opt for steroid therapy or elimination diets as first-line therapy, in contrast to most other countries. CONCLUSIONS: Significant differences in general practice between PG and AG were demonstrated with notable divergence from consensus guidelines. International practice variations are also apparent. Among other strategies, educational activities to highlight current recommendations may help harmonize and optimize clinical practice.
OBJECTIVES: The aim of the study was to assess differences in the diagnosis and management of eosinophilic esophagitis (EoE) by European pediatric (PG) and adult gastroenterologists (AG), and their self-reported adherence to guidelines. METHODS: A multiple-choice questionnaire gauged the diagnostic and management strategies of gastroenterologists treating children or adults in 14 European countries and the United Arab Emirates (UAE). RESULTS: Questionnaires were completed by 465 PG and 743 AG. PG were significantly more likely to take biopsies in patients with symptoms of esophageal dysfunction (86.2% PG vs 75.4% AG, P < 0.001) and to perform endoscopic follow-up (86.3% PG vs 80.6% AG, P < 0.001). After failure of proton-pump inhibitors (PPIs), topical steroids were the preferred second-line therapy; however, PG opted more frequently for elimination diets (47.5% PG vs 13.7% AG, P < 0.001). More PG than AG indicated having read recent guidelines (89.4% PG vs 58.2% AG, P < 0.001). Geographic differences in practice were reported, with respondents from the United Kingdom, Portugal, and Spain more often adhering to recommended biopsy protocols. Physicians in the UAE, France, Lithuania, and Poland tended to opt for steroid therapy or elimination diets as first-line therapy, in contrast to most other countries. CONCLUSIONS: Significant differences in general practice between PG and AG were demonstrated with notable divergence from consensus guidelines. International practice variations are also apparent. Among other strategies, educational activities to highlight current recommendations may help harmonize and optimize clinical practice.
Authors: Anjan Dhar; Hasan N Haboubi; Stephen E Attwood; Marcus K H Auth; Jason M Dunn; Rami Sweis; Danielle Morris; Jenny Epstein; Marco R Novelli; Hannah Hunter; Amanda Cordell; Sharon Hall; Jamal O Hayat; Kapil Kapur; Andrew Robert Moore; Carol Read; Sarmed S Sami; Paul J Turner; Nigel J Trudgill Journal: Gut Date: 2022-05-23 Impact factor: 31.793
Authors: Su Jin Kim; Moo In Park; Gwang Ha Kim; Moon Won Lee; Kyoungwon Jung; Jin Lee; Sang Young Seol; Sam Ryong Jee; Hong Sub Lee; Jin Seok Jang; Jae Hwang Cha Journal: J Neurogastroenterol Motil Date: 2021-01-30 Impact factor: 4.924