Jan Bornschein, Terry Tran-Nguyen1,2, Gloria Fernandez-Esparrach3, Stephen Ash4, Francesc Balaguer3, Elizabeth L Bird-Lieberman1,2, Henry Córdova3, Zane Dzerve5, Matteo Fassan6, Marcis Leja5, Ivan Lyutakov7, Tim Middelburg8, Leticia Moreira3, Radislav Nakov7, Stella A V Nieuwenburg8, Anthony O'Connor9, Stefano Realdon10, Heiko De Schepper11, Annemieke Smet12, M C W Spaander8, Ivars Tolmanis5, Tadas Urbonas13, Jochen Weigt14, Georgina L Hold15, Alexander Link14, Juozas Kupcinskas13. 1. Translational Gastroenterology Unit, John Radcliffe Hospital, Oxford University Hospitals, Headington, Oxford, United Kingdom. 2. NIHR Oxford Biomedical Research Centre, Oxford, United Kingdom. 3. Gastroenterology Department, Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain. 4. Nuffield Department of Medicine, Ludwig Institute for Cancer Research, University of Oxford, Oxford, United Kingdom. 5. Digestive Diseases Centre GASTRO, Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia. 6. Department of Medicine (DIMED), Surgical Pathology Unit, University of Padua, Padua, Italy. 7. Department of Gastroenterology, Tsaritsa Yoanna University Hospital, Medical University of Sofia, Sofia, Bulgaria. 8. Department of Gastroenterology & Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands. 9. Department of Gastroenterology, Tallaght University Hospital, University of Dublin, Trinity College, Dublin, Ireland. 10. Endoscopy Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy. 11. Department of Gastroenterology & Hepatology, University Hospital Antwerp, Edegem, Belgium. 12. Laboratory of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium. 13. Department of Gastroenterology and Institute for Digestive Research, Lithuanian University of Health Sciences, Kaunas, Lithuania. 14. Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University, Magdeburg, Germany. 15. Microbiome Research Centre, St George & Sutherland Clinical School, St George Hospital, University of New South Wales, Sydney, New South Wales, Australia.
Abstract
BACKGROUND: Guidelines give robust recommendations on which biopsies should be taken when there is endoscopic suggestion of gastric inflammation. Adherence to these guidelines often seems arbitrary. This study aimed to give an overview on current practice in tertiary referral centres across Europe. METHODS: Data were collected at 10 tertiary referral centres. Demographic data, the indication for each procedure, endoscopic findings, and the number and sampling site of biopsies were recorded. Findings were compared between centres, and factors influencing the decision to take biopsies were explored. RESULTS: Biopsies were taken in 56.6% of 9,425 procedures, with significant variation between centres (p < 0.001). Gastric biopsies were taken in 43.8% of all procedures. Sampling location varied with the procedure indication (p < 0.001) without consistent pattern across the centres. Fewer biopsies were taken in centres which routinely applied the updated Sydney classification for gastritis assessment (46.0%), compared to centres where this was done only upon request (75.3%, p < 0.001). This was the same for centres stratifying patients according to the OLGA system (51.8 vs. 73.0%, p < 0.001). More biopsies were taken in centres following the MAPS guidelines on stomach surveillance (68.1 vs. 37.1%, p < 0.001). Biopsy sampling was more likely in younger patients in 8 centres (p < 0.05), but this was not true for the whole cohort (p = 0.537). The percentage of procedures with biopsies correlated directly with additional costs charged in case of biopsies (r = 0.709, p = 0.022). CONCLUSION: Adherence to guideline recommendations for biopsy sampling at gastroscopy was inconsistent across the participating centres. Our data suggest that centre-specific policies are applied instead.
BACKGROUND: Guidelines give robust recommendations on which biopsies should be taken when there is endoscopic suggestion of gastric inflammation. Adherence to these guidelines often seems arbitrary. This study aimed to give an overview on current practice in tertiary referral centres across Europe. METHODS: Data were collected at 10 tertiary referral centres. Demographic data, the indication for each procedure, endoscopic findings, and the number and sampling site of biopsies were recorded. Findings were compared between centres, and factors influencing the decision to take biopsies were explored. RESULTS: Biopsies were taken in 56.6% of 9,425 procedures, with significant variation between centres (p < 0.001). Gastric biopsies were taken in 43.8% of all procedures. Sampling location varied with the procedure indication (p < 0.001) without consistent pattern across the centres. Fewer biopsies were taken in centres which routinely applied the updated Sydney classification for gastritis assessment (46.0%), compared to centres where this was done only upon request (75.3%, p < 0.001). This was the same for centres stratifying patients according to the OLGA system (51.8 vs. 73.0%, p < 0.001). More biopsies were taken in centres following the MAPS guidelines on stomach surveillance (68.1 vs. 37.1%, p < 0.001). Biopsy sampling was more likely in younger patients in 8 centres (p < 0.05), but this was not true for the whole cohort (p = 0.537). The percentage of procedures with biopsies correlated directly with additional costs charged in case of biopsies (r = 0.709, p = 0.022). CONCLUSION: Adherence to guideline recommendations for biopsy sampling at gastroscopy was inconsistent across the participating centres. Our data suggest that centre-specific policies are applied instead.
Authors: Massimo Rugge; Alberto Meggio; Cecilia Pravadelli; Mattia Barbareschi; Matteo Fassan; Maria Gentilini; Manuel Zorzi; Giovanni De Pretis; David Y Graham; Robert M Genta Journal: Gut Date: 2018-01-06 Impact factor: 23.059
Authors: Lisette G Capelle; Annemarie C de Vries; Jelle Haringsma; Frank Ter Borg; Richard A de Vries; Marco J Bruno; Herman van Dekken; Jos Meijer; Nicole C T van Grieken; Ernst J Kuipers Journal: Gastrointest Endosc Date: 2010-04-09 Impact factor: 9.427
Authors: Sabina Beg; Krish Ragunath; Andrew Wyman; Matthew Banks; Nigel Trudgill; D Mark Pritchard; Stuart Riley; John Anderson; Helen Griffiths; Pradeep Bhandari; Phillip Kaye; Andrew Veitch Journal: Gut Date: 2017-08-18 Impact factor: 23.059