Update from 2010 (standard operating procedure) : protocol for the 2024 British Society of Gastroenterology Guidelines on colorectal surveillance in inflammatory bowel disease
Gordon, Morris Nigam, Gaurav Bhaskar Sinopoulou, Vassiliki Al Bakir, Ibrahim Bateman, Adrian C Din, Shahida Dolwani, Sunil Dhar, Anjan Faiz, O D Hayee, Bu
Gordon, Morris
Nigam, Gaurav Bhaskar
Sinopoulou, Vassiliki
Al Bakir, Ibrahim
Bateman, Adrian C
Din, Shahida
Dolwani, Sunil
Dhar, Anjan
Faiz, O D
Hayee, Bu
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Affiliation
University of Central Lancashire; University of Oxford Translational Gastroenterology Unit; Chelsea and Westminster Hospital; Sandwell and West Birmingham NHS Trust; et al.
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Publication date
2024-11-29
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Abstract
Introduction: The evolving landscape of inflammatory bowel disease (IBD) necessitates refining colonoscopic surveillance guidelines. This study outlines methodology adopted by the British Society of Gastroenterology (BSG) Guideline Development Group (GDG) for updating IBD colorectal surveillance guidelines. Methods and analysis: The 'Grading of Recommendations, Assessment, Development and Evaluation' (GRADE) approach, as outlined in the GRADE handbook, was employed. Thematic questions were formulated using either the 'patient, intervention, comparison and outcome' format or the 'current state of knowledge, area of interest, potential impact and suggestions from experts in the field' format. The evidence review process included systematic reviews assessed using appropriate appraisal tools. An extensive list of potential outcomes was compiled from literature and expert consultations and then ranked by GDG members. The top outcomes were identified for evidence synthesis in three key areas: utility of surveillance in IBD, quality of bowel preparation and use of advanced imaging techniques in colonoscopy for IBD. Risk thresholding exercises determined specific risk levels for different surveillance strategies and intervals. This approach enabled the GDG to establish precise thresholds for interventions based on relative and absolute risk assessments, directly informing the stratification of surveillance recommendations. Significance of effect sizes (small, moderate, large) will guide the final GRADE assessment of the evidence. Ethics and dissemination: Ethics approval is not applicable. By integrating clinical expertise, patient experiences and innovative methodologies like risk thresholding, we aim to deliver actionable recommendations for IBD colorectal surveillance. This protocol, complementing the main guidelines, offers GDGs, clinical trialists and practitioners a framework to inform future research and enhance patient care and outcomes.
Citation
Gordon M, Nigam GB, Sinopoulou V, Al Bakir I, Bateman AC, Din S, Dolwani S, Dhar A, Faiz OD, Hayee B, Healey C, Lamb CA, Leedham S, Kabir M, Iacucci M, Hart A, Morris AJ, Novelli M, Raine T, Rutter M, Shepherd NA, Subramanian V, Trudgill NJ, Vance M, Wilson A, White L, Wakeman R, East JE. Update from 2010 (standard operating procedure): protocol for the 2024 British Society of Gastroenterology Guidelines on colorectal surveillance in inflammatory bowel disease. BMJ Open Gastroenterol. 2024 Nov 29;11(1):e001541. doi: 10.1136/bmjgast-2024-001541
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Article