Multicenter prospective validation study of the SAFE-T colonoscopy evaluation tool: a web-based smartphone application for evaluation of gastroenterology fellow performance in colonoscopy.
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SUBMITTER: Kumar NL
PROVIDER: S-EPMC8128019 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundThe COVID-19 pandemic has drastically changed healthcare systems and training around the world. The Training Committee of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition sought to understand how COVID-19 has affected pediatric gastroenterology fellowship training.MethodsA 21 question survey was distributed to all 77 pediatric gastroenterology fellowship program directors (PDs) in the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition program director database via email on April 7. Responses collected through April 19, 2020 were analyzed using descriptive statistics.ResultsFifty-one of 77 (66%) PDs from the United States, Canada, and Mexico responded to the survey. Forty-six of 51 (90%) PDs reported that they were under a "stay-at-home" order for a median of 4 weeks at the time of the survey. Two of the 51 (4%) programs had fellows participating in outpatient telehealth before COVID-19 and 39 of 51 (76%) at the time of the survey. Fellows stopped participating in outpatient clinics in 22 of 51 (43%) programs and endoscopy in 26 of 51 (52%) programs. Changes to inpatient care included reduced fellow staffing, limiting who entered patient rooms, and rounding remotely. Fellows in 3 New York programs were deployed to adult medicine units. Didactics were moved to virtual conferences in 47 of 51 (94%) programs, and fellows used various online resources. Clinical research and, disproportionately, bench research were restricted.ConclusionsThis report provides early information of the impact of COVID-19 on pediatric fellowship training. Rapid adoption of telehealth and reduced clinical and research experiences were important changes. Survey information may spur communication and innovation to help educators adapt.
| S-EPMC7273936 | biostudies-literature
Project description:Background and study aims Endoscopic mucosal resection (EMR) is an effective way to remove large (> 2 cm) colon adenomas. Training about it has not been standardized in fellowship programs. This study was aimed at evaluating the education and knowledge of gastroenterology fellows about EMR of colorectal adenomas. Methods Participation in this survey was offered to 1730 gastroenterology fellows in the United States during the academic year 2019 to 2020. The survey assessed endoscopic mucosal resection training and knowledge and was approved and administered by the American College of Gastroenterology. Results A total of 163 fellows (9.4 %) completed the survey. Only 85 fellows (52.1 %) reported receiving formal education in endoscopic mucosal resection. Fellow confidence was lowest regarding knowing electrosurgery unit settings. Fewer fellows correctly identified Paris 0-IIb (79, 48.5 %; P < 0.0001) or NICE I (114, 69.9 %; P < 0.01) lesions as compared to other Paris and NICE III lesions, respectively. Only 73 (44.8 %) and 93 fellows (57.1 %) arranged steps of EMR in the correct order and identified the correct type of current used for resection, respectively. Training year, male sex, and provision of advanced endoscopy rotations during fellowship were associated with a higher knowledge score for EMR. Conclusions Nearly half of all fellows reported no formal education in EMR and incorrectly ordered its steps. Adenoma assessment by Paris and NICE classifications and electrosurgery unit settings were the most prominent knowledge deficiencies. Incorporation of standardized training about EMR with inclusion of advanced endoscopy rotations appears to be an important educational opportunity during gastroenterology fellowship.
| S-EPMC8383077 | biostudies-literature
Project description:AimTo investigate the gastric emptying after bowel preparation to allow general anaesthesia.MethodsA prospective, non-comparative, and non-randomized trial was performed and registered on Eudra CT database (2011-002953-80) and on www.trial.gov (NCT01398098). All patients had a validated indication for colonoscopy and a preparation using sodium phosphate (NaP) tablets. The day of the procedure, patients took 4 tablets with 250 mL of water every 15 min, three times. The gastric volume was estimated every 15 min from computed antral surfaces and weight according to the formula of Perlas et al (Anesthesiology, 2009). Colonoscopy was performed within the 6 h following the last intake.ResultsThirty patients were prospectively included in the study from November 2011 to May 2012. The maximum volume of the antrum was 212 mL, achieved 15 min after the last intake. 24%, 67% and 92% of subjects had an antral volume below 20 mL at 60, 120 and 150 min, respectively. 81% of patients had a Boston score equal to 2 or 3 in each colonic segment. No adverse events leading to treatment discontinuation were reported.ConclusionGastric volume evaluation appeared to be a simple and reliable method for the assessment of gastric emptying. Data allow considering the NaP tablets bowel preparation in the morning of the procedure and confirming that gastric emptying is achieved after two hours, allowing general anaesthesia.
| S-EPMC4188911 | biostudies-literature
Project description:The aims of this study were to understand patients' willingness to use different types of health-related smartphone apps and to explore their attitudes on the overall value, usability, feasibility, credibility, intrusiveness, and obtrusiveness of these apps.Questionnaires were distributed to adult patients presenting to gastroenterology clinics at an academic medical center. The 25-question survey consisted of 5-point Likert-type scale statements, multiple-choice questions, and open-ended questions.Participants were mainly White (N=94, 78%) and smartphone owners (N=125, 93%). The mean age was 40.8 years (N=121, s.d.=13.2). Participants were willing to use most types of apps unless it monitored their location or social networking activity. Half were less willing to use an app if it required a visible accessory. Most participants were willing to use a health-related app up to 5 min a day indefinitely but unwilling to pay out-of-pocket for it. Participants generally disagreed that an app would be hard to learn how to use, interfere with their daily routine, or be embarrassing to use in public. Overall, participants felt that health-related apps could help them and their doctors better manage their medical problems, but were neutral in trusting their quality. Most worried that personal information used for an app would fall into the wrong hands.Gastroenterology patients were willing to use and valued most types of health-related apps. They perceived this technology as feasible, usable, and relatively unobtrusive unless a visible accessory was required. However, many were concerned about their privacy.
| S-EPMC4816251 | biostudies-other
Project description:BackgroundThe application of technology in the area of dietary assessment has resulted in the development of an array of tools, which are often specifically designed for a particular country or region.ObjectiveThe aim of this study was to describe the development, validation, and user evaluation of a Web-based dietary assessment tool "Foodbook24."MethodsFoodbook24 is a Web-based, dietary assessment tool consisting of a 24-hour dietary recall (24HDR) and food frequency questionnaire (FFQ) alongside supplementary questionnaires. Validity of the 24HDR component was assessed by 40 participants, who completed 3 nonconsecutive, self-administered 24HDR using Foodbook24 and a 4-day semi-weighed food diary at separate time points. Participants also provided fasted blood samples and 24-hour urine collections for the identification of biomarkers of nutrient and food group intake during each recording period. Statistical analyses on the nutrient and food group intake data derived from each method were performed in SPSS version 20.0 (SPSS Inc). Mean nutrient intakes (and standard deviations) recorded using each method of dietary assessment were calculated. Spearman and Pearson correlations, Wilcoxon Signed Rank and Paired t test were used to investigate the agreement and differences between the nutritional output from Foodbook24 (test method) and the 4-day semi-weighed food diary (reference method). Urinary and plasma biomarkers of nutrient intake were used as an objective validation of Foodbook24. To investigate the user acceptability of Foodbook24, participants from different studies involved with Foodbook24 were asked to complete an evaluation questionnaire.ResultsFor nutrient intake, correlations between the dietary assessment methods were acceptable to very good in strength and statistically significant (range r=.32 to .75). There were some significant differences between reported mean intakes of micronutrients recorded by both methods; however, with the exception of protein (P=.03), there were no significant differences in the reporting of energy or macronutrient intake. Of the 19 food groups investigated in this analysis, there were significant differences between 6 food groups reported by both methods. Spearman correlations for biomarkers of nutrient and food group intake and reported intake were similar for both methods. A total of 118 participants evaluated the acceptability of Foodbook24. The tool was well-received and the majority, 67.8% (80/118), opted for Foodbook24 as the preferred method for future dietary intake assessment when compared against a traditional interviewer led recall and semi-weighed food diary.ConclusionsThe results of this study demonstrate the validity and user acceptability of Foodbook24. The results also highlight the potential of Foodbook24, a Web-based dietary assessment method, and present a viable alternative to nutritional surveillance in Ireland.
| S-EPMC5445234 | biostudies-literature
Project description:This article describes the evaluation of an open-access web-based respiratory protective equipment selector tool (RPE-Select, accessible at http://www.healthyworkinglives.com/rpe-selector). This tool is based on the principles of the COSHH-Essentials (C-E) control banding (CB) tool, which was developed for the exposure risk management of hazardous chemicals in the workplace by small and medium sized enterprises (SMEs) and general practice H&S professionals. RPE-Select can be used for identifying adequate and suitable RPE for dusts, fibres, mist (solvent, water, and oil based), sprays, volatile solids, fumes, gases, vapours, and actual or potential oxygen deficiency. It can be applied for substances and products with safety data sheets as well as for a large number of commonly encountered process-generated substances (PGS), such as poultry house dusts or welding fume. Potential international usability has been built-in by using the Hazard Statements developed for the Globally Harmonised System (GHS) and providing recommended RPE in picture form as well as with a written specification. Illustration helps to compensate for the variabilities in assigned protection factors across the world. RPE-Select uses easily understandable descriptions/explanations and an interactive stepwise flow for providing input/answers at each step. The output of the selection process is a report summarising the user input data and a selection of RPE, including types of filters where applicable, from which the user can select the appropriate one for each wearer. In addition, each report includes 'Dos' and 'Don'ts' for the recommended RPE. RPE-Select outcomes, based on up to 20 hypothetical use scenarios, were evaluated in comparison with other available RPE selection processes and tools, and by 32 independent users with a broad range of familiarities with industrial use scenarios in general and respiratory protection in particular. For scenarios involving substances having safety data sheets, 87% of RPE-Select outcomes resulted in a 'safe' RPE selection, while 98% 'safe' outcomes were achieved for scenarios involving process-generated substances. Reasons for the outliers were examined. User comments and opinions on the mechanics and usability of RPE-Select are also presented.
| S-EPMC4965808 | biostudies-other
Project description:PurposeWeb-based questionnaires are currently the standard method for course evaluations. The high rate of smartphone adoption in Sweden makes possible a range of new uses, including course evaluation. This study examines the potential advantages and disadvantages of using a smartphone app as a complement to web-based course evaluationsystems.MethodsAn iPhone app for course evaluations was developed and interfaced to an existing web-based tool. Evaluations submitted using the app were compared with those submitted using the web between August 2012 and June 2013, at the Faculty of Medicine at Uppsala University, Sweden.ResultsAt the time of the study, 49% of the students were judged to own iPhones. Over the course of the study, 3,340 evaluations were submitted, of which 22.8% were submitted using the app. The median of mean scores in the submitted evaluations was 4.50 for the app (with an interquartile range of 3.70-5.20) and 4.60 (3.70-5.20) for the web (P=0.24). The proportion of evaluations that included a free-text comment was 50.5% for the app and 49.9% for the web (P=0.80).ConclusionAn app introduced as a complement to a web-based course evaluation system met with rapid adoption. We found no difference in the frequency of free-text comments or in the evaluation scores. Apps appear to be promising tools for course evaluations. web-based course evaluation system met with rapid adoption. We found no difference in the frequency of free-text comments or in the evaluation scores. Apps appear to be promising tools for course evaluations.
| S-EPMC4722169 | biostudies-literature
Project description:BackgroundInpatient colonoscopy bowel preparation (ICBP) is frequently inadequate and can lead to adverse events, delayed or repeated procedures, and negative patient outcomes. Guidelines to overcome the complex factors in this setting are not well established. Our aims were to use health systems engineering principles to comprehensively evaluate the ICBP process, create an ICBP protocol, increase adequate ICBP, and decrease length of stay. Our goal was to provide adaptable tools for other institutions and procedural specialties.MethodsPatients admitted to our tertiary care academic hospital that underwent inpatient colonoscopy between July 3, 2017 to June 8, 2018 were included. Our multi-disciplinary team created a protocol employing health systems engineering techniques (i.e., process mapping, cause-effect diagrams, and plan-do-study-act cycles). We collected demographic and colonoscopy data. Our outcome measures were adequate preparation and length of stay. We compared pre-intervention (120 ICBP) vs. post-intervention (129 ICBP) outcomes using generalized linear regression models. Our new ICBP protocol included: split-dose 6-L polyethylene glycol-electrolyte solution, a gastroenterology electronic note template, and an education plan for patients, nurses, and physicians.ResultsThe percent of adequate ICBPs significantly increased with the intervention from 61% pre-intervention to 74% post-intervention (adjusted odds ratio of 1.87, p value = 0.023). The median length of stay decreased by approximately 25%, from 4 days pre-intervention to 3 days post-intervention (p value = 0.11).ConclusionsBy addressing issues at patient, provider, and system levels with health systems engineering principles, we addressed patient safety and quality of care provided by improving rates of adequate ICBP.
| S-EPMC7912514 | biostudies-literature
Project description:Endoscopy training is a central component of gastroenterology training for the vast majority of UK trainees, and integral to this is the practice of safe sedation. The majority of endoscopic procedures are performed with the patient under conscious sedation with a benzodiazepine, often combined with an opioid. Little data exists on the practice of sedation among gastroenterology trainees, including their degree of knowledge of the common sedation agents used and their actions. Using both an online and paper-based questionnaire, we surveyed current gastroenterology speciality trainees (ST) in the UK and received 78 responses giving a response rate of 10%. Fifty-one per cent of the trainees did not receive structured training in safe sedation, despite national guidelines advising this to be an essential part of the training programme, and 92% felt a structured sedation course would be beneficial. We also identified some gaps in trainees' knowledge of the action of sedation agents. We propose that a formal training session in sedation or an e-learning module could be incorporated as part of a deanery or trust induction for gastroenterology trainees and kept under regular review.
| S-EPMC5369579 | biostudies-other
Project description:BackgroundGene fusions often occur in cancer cells and in some cases are the main driver of oncogenesis. Correct identification of oncogenic gene fusions thus has implications for targeted cancer therapy. Recognition of this potential has led to the development of a myriad of sequencing-based fusion detection tools. However, given the same input, many of these detectors will find different fusion points or claim different sets of supporting data. Furthermore, the rate at which these tools falsely detect fusion events in data varies greatly. This discrepancy between tools underscores the fact that computation algorithms still cannot perfectly evaluate evidence; especially when provided with small amounts of supporting data as is typical in fusion detection. We assert that when evidence is provided in an easily digestible form, humans are more proficient in identifying true positives from false positives.ResultsWe have developed a web tool that, given the genomic coordinates of a candidate fusion breakpoint, will extract fusion and non-fusion reads adjacent to the fusion point from partner transcripts, and color code reads by transcript origin and read orientation for ease of intuitive inspection by the user. Fusion partner transcript read alignments are performed using a novel variant of the Smith-Waterman algorithm.ConclusionsCombined with dynamic filtering parameters, the visualization provided by our tool introduces a powerful new investigative step that allows researchers to comprehensively evaluate fusion evidence. Additionally, this allows quick identification of false positives that may deceive most fusion detectors, thus eliminating unnecessary gene fusion validation. We apply our visualization tool to publicly available datasets and provide examples of true as well as false positives reported by open source fusion detection tools.
| S-EPMC5812216 | biostudies-literature