AIM To study implications of measuring quality indicators on training and trainees' performance in pediatric colonoscopy in a low-volume training center.METHODS We reviewed retrospectively the performance of pedia...AIM To study implications of measuring quality indicators on training and trainees' performance in pediatric colonoscopy in a low-volume training center.METHODS We reviewed retrospectively the performance of pediatric colonoscopies in a training center in Malaysia over 5 years(January 2010-December 2015), benchmarked against five quality indicators: appropriateness of indications, bowel preparations, cecum and ileal examination rates, and complications. The European Society of Gastrointestinal Endoscopy guideline for pediatric endoscopy and North American Society for Pediatric Gastroenterology, Hepatology and Nutrition training guidelines were used as benchmarks.RESULTS Median(± SD) age of 121 children [males = 74(61.2%)] who had 177 colonoscopies was 7.0(± 4.6) years. On average, 30 colonoscopies were performed each year(range: 19-58). Except for investigations of abdominal pain(21/177, 17%), indications for colonoscopies were appropriate in the remaining 83%. Bowel preparation was good in 87%. One patient(0.6%) with severe Crohn's disease had bowel perforation. Cecum examination and ileal intubation rate was 95% and 68.1%. Ileal intubation rate was significantly higher in diagnosing or assessing inflammatory bowel disease(IBD) than non-IBD(72.9% vs 50.0%; P = 0.016). Performance of four trainees was consistent throughout the study period. Average cecum and ileal examination rate among trainees were 97% and 77%.CONCLUSION Benchmarking against established guidelines helps units with a low-volume of colonoscopies to identify area for further improvement.展开更多
BACKGROUND There remains a dearth of Asian epidemiological literature for paediatric inflammatory bowel disease(PIBD).AIM To describe the presenting features of PIBD from 7 Asia-Pacific pediatric gastroenterology cent...BACKGROUND There remains a dearth of Asian epidemiological literature for paediatric inflammatory bowel disease(PIBD).AIM To describe the presenting features of PIBD from 7 Asia-Pacific pediatric gastroenterology centers via a central standardised electronic data platform.METHODS Clinical,endoscopic and radiologic data at diagnosis from the registry were extracted between 1^(st) January 1995 to 31^(st) December 2019.Disease phenotypic characteristics were classified as per the Paris classification system.RESULTS There was a distinct rise in new PIBD cases:Nearly half(48.6%)of the cohort was diagnosed in the most recent 5 years(2015-2019).The ratio of Crohn’s disease(CD):Ulcerative colitis(UC):IBDUnclassified was 55.9%:38.3%:5.8%.The mean age was 9.07 years with a high proportion of very early onset IBD(VEO-IBD)(29.3%)and EO-IBD(52.7%).An over-representation of the Indian/South Asian ethnic group was observed which accounted for 37.0% of the overall Singapore/Malaysia subcohort(6.8%-9.0%Indians in census).Indian/South Asian CD patients were also most likely to present with symptomatic perianal disease(P=0.003).CD patients presented with significantly more constitutional symptoms(fever,anorexia,malaise/fatigue and muscle-wasting)than UC and higher inflammatory indices(higher C-reactive protein and lower albumin levels).CONCLUSION We observed a high incidence of VEO-IBD and an over-representation of the Indian ethnicity.South Asian CD patients were more likely to have symptomatic perianal disease.展开更多
基金Supported by Research grant from Ministry of Higher Education,Malaysia,No.UM.C/625/HIR/MOHE/CHAN/13/1
文摘AIM To study implications of measuring quality indicators on training and trainees' performance in pediatric colonoscopy in a low-volume training center.METHODS We reviewed retrospectively the performance of pediatric colonoscopies in a training center in Malaysia over 5 years(January 2010-December 2015), benchmarked against five quality indicators: appropriateness of indications, bowel preparations, cecum and ileal examination rates, and complications. The European Society of Gastrointestinal Endoscopy guideline for pediatric endoscopy and North American Society for Pediatric Gastroenterology, Hepatology and Nutrition training guidelines were used as benchmarks.RESULTS Median(± SD) age of 121 children [males = 74(61.2%)] who had 177 colonoscopies was 7.0(± 4.6) years. On average, 30 colonoscopies were performed each year(range: 19-58). Except for investigations of abdominal pain(21/177, 17%), indications for colonoscopies were appropriate in the remaining 83%. Bowel preparation was good in 87%. One patient(0.6%) with severe Crohn's disease had bowel perforation. Cecum examination and ileal intubation rate was 95% and 68.1%. Ileal intubation rate was significantly higher in diagnosing or assessing inflammatory bowel disease(IBD) than non-IBD(72.9% vs 50.0%; P = 0.016). Performance of four trainees was consistent throughout the study period. Average cecum and ileal examination rate among trainees were 97% and 77%.CONCLUSION Benchmarking against established guidelines helps units with a low-volume of colonoscopies to identify area for further improvement.
文摘BACKGROUND There remains a dearth of Asian epidemiological literature for paediatric inflammatory bowel disease(PIBD).AIM To describe the presenting features of PIBD from 7 Asia-Pacific pediatric gastroenterology centers via a central standardised electronic data platform.METHODS Clinical,endoscopic and radiologic data at diagnosis from the registry were extracted between 1^(st) January 1995 to 31^(st) December 2019.Disease phenotypic characteristics were classified as per the Paris classification system.RESULTS There was a distinct rise in new PIBD cases:Nearly half(48.6%)of the cohort was diagnosed in the most recent 5 years(2015-2019).The ratio of Crohn’s disease(CD):Ulcerative colitis(UC):IBDUnclassified was 55.9%:38.3%:5.8%.The mean age was 9.07 years with a high proportion of very early onset IBD(VEO-IBD)(29.3%)and EO-IBD(52.7%).An over-representation of the Indian/South Asian ethnic group was observed which accounted for 37.0% of the overall Singapore/Malaysia subcohort(6.8%-9.0%Indians in census).Indian/South Asian CD patients were also most likely to present with symptomatic perianal disease(P=0.003).CD patients presented with significantly more constitutional symptoms(fever,anorexia,malaise/fatigue and muscle-wasting)than UC and higher inflammatory indices(higher C-reactive protein and lower albumin levels).CONCLUSION We observed a high incidence of VEO-IBD and an over-representation of the Indian ethnicity.South Asian CD patients were more likely to have symptomatic perianal disease.
