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Article ; Online: Editorial: increasing IBD prevalence and its complications in the context of the COVID-19 pandemic. Authors' reply.

King, Dominic Stephen / Trudgill, Nigel John / Adderley, Nicola J

2020 Volume 51, Issue 12, Page(s) 1442–1443

MeSH term(s)	Betacoronavirus ; COVID-19 ; Coronavirus Infections ; Humans ; Inflammatory Bowel Diseases ; Pandemics ; Pneumonia, Viral ; Prevalence ; SARS-CoV-2
Keywords	covid19
Language	English
Publishing date	2020-05-14
Publishing country	England
Document type	Editorial ; Comment
ZDB-ID	639012-2
ISSN	1365-2036 ; 0269-2813 ; 0953-0673
ISSN (online)	1365-2036
ISSN	0269-2813 ; 0953-0673
DOI	10.1111/apt.15769
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Article: Management of iron deficiency anaemia in secondary care across England between 2012 and 2018: a real-world analysis of Hospital Episode Statistics.

Brookes, Matthew James / Farr, Angela / Phillips, Ceri J / Trudgill, Nigel John

Frontline gastroenterology

2020 Volume 12, Issue 5, Page(s) 363–369

Abstract: Objective: Iron deficiency anaemia (IDA) occurs in 2%-5% of men and postmenopausal women in the developed world and, if left untreated, can significantly impair quality of life or decompensate chronic illnesses. Approximately 10% of men and ... ...

Abstract	Objective: Iron deficiency anaemia (IDA) occurs in 2%-5% of men and postmenopausal women in the developed world and, if left untreated, can significantly impair quality of life or decompensate chronic illnesses. Approximately 10% of men and postmenopausal women with IDA have underlying gastrointestinal malignancy. This study identifies trends in the management of IDA in secondary care in England. Design/method: The Hospital Episode Statistics database was used to analyse IDA-related hospital and outpatient admissions (elective and non-elective) in National Health Service England between April 2012 and March 2018. Outcome measures included rates of readmission, length of stay (LOS) and cost per admission. Results: Between 2012/2013 and 2017/2018, there was a 72% increase in hospital admissions for patients with a primary diagnosis of IDA and a 68% increase in hospital spells, with the number of cases being managed non-electively increasing by 58%. Non-electively managed patients had a longer LOS (3.10 vs 0.04 days, respectively) and increased rate of readmissions within 30 days (24.1% vs 6.6%) versus patients managed electively. Average day-case cost was £449 versus £1676 for non-elective admission. Across the 195 clinical commissioning groups (CCGs) in England, non-elective spells per 100 000 population demonstrated extensive and widening variability, ranging from 18 to 118 in 2017/2018 compared with 11-55 in 2012/2013. Conclusion: The current analysis highlights several opportunities to improve patient outcomes and reduce costs. There is an opportunity to improve day-case services by looking at the difference between CCGs and the variability in care and to reduce the number of non-elective admissions.
Language	English
Publishing date	2020-10-26
Publishing country	England
Document type	Journal Article
ZDB-ID	2521857-8
ISSN	2041-4137
ISSN	2041-4137
DOI	10.1136/flgastro-2020-101506
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Article: Editorial: increasing IBD prevalence and its complications in the context of the COVID-19 pandemic. Authors' reply

King, Dominic Stephen / Trudgill, Nigel John / Adderley, Nicola J

Aliment Pharmacol Ther

Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #260367
Database	COVID19

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Article ; Online: Editorial

King, Dominic Stephen / Trudgill, Nigel John / Adderley, Nicola J.

Alimentary Pharmacology & Therapeutics

increasing IBD prevalence and its complications in the context of the COVID-19 pandemic. Authors' reply

2020 Volume 51, Issue 12, Page(s) 1442–1443

Keywords	Pharmacology (medical) ; covid19
Language	English
Publisher	Wiley
Publishing country	us
Document type	Article ; Online
ZDB-ID	639012-2
ISSN	1365-2036 ; 0269-2813 ; 0953-0673
ISSN (online)	1365-2036
ISSN	0269-2813 ; 0953-0673
DOI	10.1111/apt.15769
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: UK endoscopy workload and workforce patterns: is there potential to increase capacity? A BSG analysis of the National Endoscopy Database.

Beaton, David / Sharp, Linda / Trudgill, Nigel John / Thoufeeq, Mo / Nicholson, Brian D / Rogers, Peter / Docherty, James / Penman, Ian D / Rutter, Matt

Frontline gastroenterology

2022 Volume 14, Issue 2, Page(s) 103–110

Abstract: Background: The lack of comprehensive national data on endoscopy activity and workforce hampers strategic planning. The National Endoscopy Database (NED) provides a unique opportunity to address this in the UK. We evaluated NED to inform service ... ...

Abstract	Background: The lack of comprehensive national data on endoscopy activity and workforce hampers strategic planning. The National Endoscopy Database (NED) provides a unique opportunity to address this in the UK. We evaluated NED to inform service planning, exploring opportunities to expand capacity to meet service demands. Design: Data on all procedures between 1 March 2019 and 29 February 2020 were extracted from NED. Endoscopy activity and endoscopist workforce were analysed. Results: 1 639 640 procedures were analysed (oesophagogastroduodenoscopy (OGD) 693 663, colonoscopy 586 464, flexible sigmoidoscopy 335 439 and endoscopic retrograde cholangiopancreatography 23 074) from 407 sites by 4990 endoscopists. 89% of procedures were performed in NHS sites. 17% took place each weekday, 10% on Saturdays and 6% on Sundays. Training procedures accounted for 6% of total activity, over 99% of which took place in NHS sites. Median patient age was younger in the independent sector (IS) (51 vs 60 years, p<0.001). 74% of endoscopists were male. Gastroenterologists and surgeons each comprised one-third of the endoscopist workforce; non-medical endoscopists (NMEs) comprised 12% yet undertook 23% of procedures. Approximately half of endoscopists performing OGD (52%) or colonoscopies (48%) did not meet minimum annual procedure numbers. Conclusion: This comprehensive analysis reveals endoscopy workload and workforce patterns for the first time across both the NHS and the IS in all four UK nations. Half of all endoscopists perform fewer than the recommended minimum annual procedure numbers: a national strategy to address this, along with expansion of the NME workforce, would increase endoscopy capacity, which could be used to exploit latent weekend capacity.
Language	English
Publishing date	2022-06-20
Publishing country	England
Document type	Journal Article
ZDB-ID	2521857-8
ISSN	2041-4137
ISSN	2041-4137
DOI	10.1136/flgastro-2022-102145
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Article: Insight from patients and healthcare professionals on the implementation of virtual clinics in patients with inflammatory bowel disease.

Kumar, Aditi / Quraishi, Mohammed Nabil / de Silva, Shanika / Trudgill, Nigel John / Steed, Helen / Brookes, Matthew James / Cooney, Rachel

Frontline gastroenterology

2021 Volume 13, Issue 2, Page(s) 104–110

Abstract: Introduction: During COVID-19, the management of outpatient inflammatory bowel disease (IBD) changed from face-to-face (F2F) to telephone and video consultations across the UK. We surveyed patients with IBD and IBD healthcare professionals (HCPs) to ... ...

Abstract	Introduction: During COVID-19, the management of outpatient inflammatory bowel disease (IBD) changed from face-to-face (F2F) to telephone and video consultations across the UK. We surveyed patients with IBD and IBD healthcare professionals (HCPs) to evaluate the impact of this abrupt transition on patient and HCP satisfaction outcomes, including the barriers and enablers of this service. Methods: Patient satisfaction surveys were sent to patients who had a telephone consultation from May to July 2020. A second survey was sent to IBD HCPs across the UK. Questions from both surveys consisted of a mixture of multiple-choice options, ranking answers as well as short-answer questions. Results: 210 patients and 114 HCPs completed the survey. During COVID-19, there was a significantly greater use of telephone, video or a mixture of consultation. F2F consultations were consistently preferred by patients, with 50% of patients indicating they did not want the option of for video consultations. Patients were more likely to prefer a telephone consultation if they were stable and needed routine review. Significantly fewer HCPs (5.3%) intend to use F2F consultations alone, preferring the use of telephone (20.2%) or combinations of telephone/F2F (22.8%), telephone/video (4.4%) or combination of all three consultation types (34.2%). 63% indicated they intend to incorporate video consultations in the future. Conclusion: Telephone and video consultations need to be balanced proportionately with F2F clinics to achieve both patient and HCP satisfaction. Further research needs to be done to explore the use of video medicine in patients with IBD.
Language	English
Publishing date	2021-02-25
Publishing country	England
Document type	Journal Article
ZDB-ID	2521857-8
ISSN	2041-4137
ISSN	2041-4137
DOI	10.1136/flgastro-2020-101714
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Article: JAG consensus statements for training and certification in oesophagogastroduodenoscopy.

Siau, Keith / Beales, Ian L P / Haycock, Adam / Alzoubaidi, Durayd / Follows, Rachael / Haidry, Rehan / Mannath, Jayan / McConnell, Susan / Murugananthan, Aravinth / Ravindran, Srivathsan / Riley, Stuart A / Williams, R N / Trudgill, Nigel John / Veitch, Andrew M

Frontline gastroenterology

2022 Volume 13, Issue 3, Page(s) 193–205

Abstract: Introduction: Training and quality assurance in oesophagogastroduodenoscopy (OGD) is important to ensure competent practice. A national evidence-based review was undertaken to update and develop standards and recommendations for OGD training and ... ...

Abstract	Introduction: Training and quality assurance in oesophagogastroduodenoscopy (OGD) is important to ensure competent practice. A national evidence-based review was undertaken to update and develop standards and recommendations for OGD training and certification. Methods: Under the oversight of the Joint Advisory Group (JAG), a modified Delphi process was conducted with stakeholder representation from British Society of Gastroenterology, Association of Upper Gastrointestinal Surgeons, trainees and trainers. Recommendations on OGD training and certification were formulated following literature review and appraised using Grading of Recommendations Assessment, Development and Evaluation. These were subjected to electronic voting to achieve consensus. Accepted statements were incorporated into the updated certification pathway. Results: In total, 32 recommendation statements were generated for the following domains: definition of competence (4 statements), acquisition of competence (12 statements), assessment of competence (10 statements) and post-certification support (6 statements). The consensus process led to following certification criteria: (1) performing ≥250 hands-on procedures; (2) attending a JAG-accredited basic skills course; (3) attainment of relevant minimal performance standards defined by British Society of Gastroenterology/Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland, (4) achieving physically unassisted D2 intubation and J-manoeuvre in ≥95% of recent procedures, (5) satisfactory performance in formative and summative direct observation of procedural skills assessments. Conclusion: The JAG standards for diagnostic OGD have been updated following evidence-based consensus. These standards are intended to support training, improve competency assessment to uphold standards of practice and provide support to the newly-independent practitioner.
Language	English
Publishing date	2022-01-24
Publishing country	England
Document type	Journal Article
ZDB-ID	2521857-8
ISSN	2041-4137
ISSN	2041-4137
DOI	10.1136/flgastro-2021-101907
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Article ; Online: Hiatal hernia diagnosis prospectively assessed in obese patients before bariatric surgery: accuracy of high-resolution manometry taking intraoperative diagnosis as reference standard.

Santonicola, Antonella / Angrisani, Luigi / Vitiello, Antonio / Tolone, Salvatore / Trudgill, Nigel John / Ciacci, Carolina / Iovino, Paola

Surgical endoscopy

2019 Volume 34, Issue 3, Page(s) 1150–1156

Abstract: Background: Hiatal hernia (HH) is common in obese patients undergoing bariatric surgery. Preoperative traditional techniques such as upper gastrointestinal endoscopy (UGIE) or barium swallow/esophagram do not always correlate with intraoperative ... ...

Abstract	Background: Hiatal hernia (HH) is common in obese patients undergoing bariatric surgery. Preoperative traditional techniques such as upper gastrointestinal endoscopy (UGIE) or barium swallow/esophagram do not always correlate with intraoperative findings. High-resolution manometry (HRM) has shown a higher sensitivity and specificity than traditional techniques in non-obese patients in the HH diagnosis, whereas there is a lack of data in the morbidly obese population. We aimed to prospectively assess the diagnostic accuracy of HRM in HH detection, in comparison with barium swallow and UGIE, assuming intraoperative diagnosis as a standard of reference. Methods: Forty-one consecutive morbidly obese patients prospectively recruited from a tertiary-care referral hospital devoted to bariatric and metabolic surgery underwent a preoperative evaluation including standardized GERD questionnaires, barium swallow, UGIE, and HRM. The surgical procedures were performed by a single surgeon who was blinded to the results of other investigations. Results: HH was intraoperatively diagnosed in 11/41 patients (26.8%). In 10/11 patients, the preoperative HRM showed an esophagogastric junction suggestive of HH. When compared to intraoperative evaluation, the sensitivity of the HRM was 90.9% and the specificity 63.3%, with a positive predictive value of 47.6% and a negative predictive value of 95.0%. HRM showed a higher sensitivity and specificity compared to barium swallow and UGIE. Conclusions: HRM has a high accuracy of HH detection in morbidly obese patients assuming an intraoperative diagnosis as reference standard. It could therefore be a very useful tool in the preoperative work-up of obese patients undergoing bariatric surgery.
MeSH term(s)	Adult ; Bariatric Surgery ; Esophagogastric Junction ; Female ; Hernia, Hiatal/complications ; Hernia, Hiatal/diagnosis ; Humans ; Male ; Manometry/methods ; Middle Aged ; Obesity, Morbid/complications ; Obesity, Morbid/surgery ; Predictive Value of Tests ; Preoperative Care/methods ; Reference Values ; Sensitivity and Specificity
Language	English
Publishing date	2019-05-28
Publishing country	Germany
Document type	Journal Article
ZDB-ID	639039-0
ISSN	1432-2218 ; 0930-2794
ISSN (online)	1432-2218
ISSN	0930-2794
DOI	10.1007/s00464-019-06865-0
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Article: The 2015 upper gastrointestinal "Be Clear on Cancer" campaign: its impact on gastroenterology services and malignant and premalignant diagnoses.

Siau, Keith / Yew, Andrew Chong / Hingley, Samantha / Rees, James / Trudgill, Nigel John / Veitch, Andrew M / Fisher, Neil C

Frontline gastroenterology

2017 Volume 8, Issue 4, Page(s) 284–289

Abstract: Objective: To assess the impact of the upper gastrointestinal 'Be Clear on Cancer' campaign launched by Public Health England between January and February 2015 on open-access gastroscopy referrals, incidence of target diagnoses (oesophagogastric cancer ... ...

Abstract	Objective: To assess the impact of the upper gastrointestinal 'Be Clear on Cancer' campaign launched by Public Health England between January and February 2015 on open-access gastroscopy referrals, incidence of target diagnoses (oesophagogastric cancer and Barrett's oesophagus), cancer staging at presentation, 1-year survival and cost per additional diagnosis. Design: We performed a retrospective study of patients referred for 2-week-wait (2WW), open-access endoscopy 3 months following the campaign with diagnoses, endoscopic findings, staging and 12-month survival compared with data from corresponding months in 2014. Setting: Three adjacent National Health Service trusts in the West Midlands with a combined population of 1.34 million in 2015. Results: 2WW open-access referrals increased by 48% (95% CI 1.35 to 1.61, p<0.001). The proportion of target diagnoses fell from 6.7% to 6.1% (p=0.62). There were no significant overall increases in target diagnoses (OR 1.35, 95% CI 0.95 to 1.92, p=0.11) or cancer (OR 1.30, 95% CI 0.80 to 2.07, p=0.36). There was no change in tumour, node, metastasis (TNM) staging for oesophageal or gastric cancer. Overall 1-year survival did not alter significantly (HR 1.10, 95% CI 0.56 to 2.19, p=0.76). Discussion: The 'Be Clear on Cancer' campaign led to a 48% increase in demand for 2WW gastroscopies but did not significantly affect the incidence of target diagnoses, cancer staging or 1-year survival.
Language	English
Publishing date	2017-06-29
Publishing country	England
Document type	Journal Article
ZDB-ID	2521857-8
ISSN	2041-4137
ISSN	2041-4137
DOI	10.1136/flgastro-2017-100820
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Article ; Online: Influence of age and sex on endoscopic findings of gastrooesophageal reflux disease: an endoscopy database study.

Menon, Shyam / Jayasena, Hiruni / Nightingale, Peter / Trudgill, Nigel John

European journal of gastroenterology & hepatology

2011 Volume 23, Issue 5, Page(s) 389–395

Abstract: Background: Barrett's oesophagus (BO) and oesophageal adenocarcinoma are more common with increasing age and among men. Symptoms of gastrooesophageal reflux disease are equally common in both sexes and at all ages. We hypothesized that reduced ... ...

Abstract	Background: Barrett's oesophagus (BO) and oesophageal adenocarcinoma are more common with increasing age and among men. Symptoms of gastrooesophageal reflux disease are equally common in both sexes and at all ages. We hypothesized that reduced postmenopausal female sex hormone levels may remove protection from acid reflux injury, leading to increased oesophagitis and its complications in older women. Aim: To examine the incidence of gastrooesophageal reflux disease and its complications in men and women in a large endoscopy database. Methods: Anonymized data were extracted from endoscopy databases covering an 11-year period. Patients with an endoscopic diagnosis of reflux oesophagitis (RO), BO, hiatus hernia and benign oesophageal stricture and total number and indications for endoscopies were identified. Results: Out of 154 406 upper gastrointestinal endoscopies, 24 240 (15.7%) patients had RO {13,148 male, 11,092 female, mean age 59 [standard deviation (SD) 17] years}. The incidence of RO increased with age {odds ratio 1.029 [95% confidence interval (CI) 1.026-1.032], P<0.001} but this increase was more marked in women with increasing age [1.01 (1.01-1.02), P<0.001] compared with men. Increasing age was associated with an increased incidence of benign oesophageal stricture [1.02 (1.017-1.023)] and BO [1.02 (1.019-1.021)]. Although the increase in benign oesophageal stricture was more marked in women [1.024 (1.02-1.028) P<0.001] than in men, this was not the case in BO. Conclusion: RO and its complications, BO and benign oesophageal stricture increase with age. RO, BO and stricture are more common in absolute and relative terms among younger men than younger women. RO and stricture increase more rapidly in women than men so that the prevalence in elderly patients is similar in both sexes.
MeSH term(s)	Adenocarcinoma/epidemiology ; Adenocarcinoma/pathology ; Adult ; Age Factors ; Aged ; Barrett Esophagus/epidemiology ; Barrett Esophagus/pathology ; Endoscopy ; Esophageal Neoplasms/epidemiology ; Esophageal Neoplasms/pathology ; Female ; Gastroesophageal Reflux/epidemiology ; Gastroesophageal Reflux/pathology ; Hernia, Hiatal/diagnosis ; Hernia, Hiatal/epidemiology ; Hernia, Hiatal/pathology ; Humans ; Incidence ; Male ; Middle Aged ; Prevalence ; Retrospective Studies ; Sex Factors
Language	English
Publishing date	2011-05
Publishing country	England
Document type	Journal Article
ZDB-ID	1034239-4
ISSN	1473-5687 ; 0954-691X
ISSN (online)	1473-5687
ISSN	0954-691X
DOI	10.1097/MEG.0b013e328345d429
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