Quality indicators for Barrett's endotherapy (QBET): UK consensus statements for patients undergoing endoscopic therapy for Barrett's neoplasia

Durayd Alzoubaidi¹, Krish Ragunath², Sachin Wani³, Ian D Penman⁴, Nigel John Trudgill⁵, Marnix Jansen⁶, Matthew Banks⁷, Pradeep Bhandari⁸, Allan John Morris⁹, Robert Willert¹⁰, Phil Boger¹¹, Howard L Smart¹², Narayanasamy Ravi¹³, Jason Dunn¹⁴, Charles Gordon¹⁵, Jayan Mannath¹⁶, Inder Mainie¹⁷, Massi di Pietro¹⁸, Andrew M Veitch¹⁹, Sally Thorpe²⁰, Cormac Magee^{21

22}, Martin Everson²⁰, Sarmed Sami²⁰, Paul Bassett²³, David Graham²⁰, Stephen Attwood²⁴, Oliver Pech²⁵, Prateek Sharma²⁶, Laurence B Lovat²⁷, Rehan Haidry²⁸

Affiliations

¹ Division of Surgery and Interventional Science, University College London (UCL), London, UK.
² Department of Gastroenterology, Queens Medical Centre, University Hospital Nottingham, Nottingham, UK.
³ Division of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
⁴ Gastrointestinal Unit, Western General Hospital, Edinburgh, UK.
⁵ Gastroenterology, Sandwell General Hospital, West Bromwich, UK.
⁶ Department of Histopathology, University College London Hospital, London, UK.
⁷ Department of Gastroenterology, University College London Hospital, London, UK.
⁸ Department of Gastroenterology, Queen Alexandra Hospital Portsmouth, Portsmouth, UK.
⁹ Department of Gastroenterology, Glasgow Royal Infirmary, Glasgow, UK.
¹⁰ Department of Gastroenterology, Manchester Royal Infirmary, Manchester, UK.
¹¹ Department of Gastroenterology, University Hospital Southampton, Southampton, UK.
¹² Department of Gastroenterology, Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, Merseyside, UK.
¹³ Division of Surgery, St James's Hospital, Dublin, Ireland.
¹⁴ Department of Gastroenterology, Guy's and St Thomas' Hospital, London, UK.
¹⁵ Department of Gastroenterology, Royal Bournemouth Hospital, Bournemouth, UK.
¹⁶ Department of Gastroenterology, Coventry and Warwickshire NHS Trust, Coventry, UK.
¹⁷ Department of Gastroenterology, Belfast City Hospital, Belfast, UK.
¹⁸ MRC Cancer Unit, University of Cambridge, Cambridge, UK.
¹⁹ Department of Gastroenterology, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK.
²⁰ Department of Gastroenterology, University Colleg London Hospital, London, UK.
²¹ Department of Gastroenterology, University College London Hospital, Londons, UK.
²² Metabolism and Experimental Therapeutic, University College London Division of Biosciences, London, UK.
²³ Statsconsultancy, Amersham, UK.
²⁴ Department of Health Services Research, Durham University, Durham, UK.
²⁵ Department of Medicine, HSK Wiesbaden, Wiesbaden, Germany.
²⁶ Department of Gastroenterology, University of Kansas, Kansas City, Kansas, USA.
²⁷ Division of Surgery and Interventional Science, University College London (UCL), Londons, UK.
²⁸ Department of Gastroenterology and Division of Surgery and Interventional Science, University College London Hospitals NHS Foundation Trust, London, UK.

PMID: 32587669
PMCID: PMC7307052
DOI: 10.1136/flgastro-2019-101247

Quality indicators for Barrett's endotherapy (QBET): UK consensus statements for patients undergoing endoscopic therapy for Barrett's neoplasia

Durayd Alzoubaidi et al. Frontline Gastroenterol. 2019.

. 2019 Aug 14;11(4):259-271.

doi: 10.1136/flgastro-2019-101247. eCollection 2020.

Authors

Affiliations

¹ Division of Surgery and Interventional Science, University College London (UCL), London, UK.
² Department of Gastroenterology, Queens Medical Centre, University Hospital Nottingham, Nottingham, UK.
³ Division of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
⁴ Gastrointestinal Unit, Western General Hospital, Edinburgh, UK.
⁵ Gastroenterology, Sandwell General Hospital, West Bromwich, UK.
⁶ Department of Histopathology, University College London Hospital, London, UK.
⁷ Department of Gastroenterology, University College London Hospital, London, UK.
⁸ Department of Gastroenterology, Queen Alexandra Hospital Portsmouth, Portsmouth, UK.
⁹ Department of Gastroenterology, Glasgow Royal Infirmary, Glasgow, UK.
¹⁰ Department of Gastroenterology, Manchester Royal Infirmary, Manchester, UK.
¹¹ Department of Gastroenterology, University Hospital Southampton, Southampton, UK.
¹² Department of Gastroenterology, Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, Merseyside, UK.
¹³ Division of Surgery, St James's Hospital, Dublin, Ireland.
¹⁴ Department of Gastroenterology, Guy's and St Thomas' Hospital, London, UK.
¹⁵ Department of Gastroenterology, Royal Bournemouth Hospital, Bournemouth, UK.
¹⁶ Department of Gastroenterology, Coventry and Warwickshire NHS Trust, Coventry, UK.
¹⁷ Department of Gastroenterology, Belfast City Hospital, Belfast, UK.
¹⁸ MRC Cancer Unit, University of Cambridge, Cambridge, UK.
¹⁹ Department of Gastroenterology, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK.
²⁰ Department of Gastroenterology, University Colleg London Hospital, London, UK.
²¹ Department of Gastroenterology, University College London Hospital, Londons, UK.
²² Metabolism and Experimental Therapeutic, University College London Division of Biosciences, London, UK.
²³ Statsconsultancy, Amersham, UK.
²⁴ Department of Health Services Research, Durham University, Durham, UK.
²⁵ Department of Medicine, HSK Wiesbaden, Wiesbaden, Germany.
²⁶ Department of Gastroenterology, University of Kansas, Kansas City, Kansas, USA.
²⁷ Division of Surgery and Interventional Science, University College London (UCL), Londons, UK.
²⁸ Department of Gastroenterology and Division of Surgery and Interventional Science, University College London Hospitals NHS Foundation Trust, London, UK.

PMID: 32587669
PMCID: PMC7307052
DOI: 10.1136/flgastro-2019-101247

Abstract

Introduction: Endoscopic therapy for the management of patients with Barrett's oesophagus (BE) neoplasia has significantly developed in the past decade; however, significant variation in clinical practice exists. The aim of this project was to develop expert physician-lead quality indicators (QIs) for Barrett's endoscopic therapy.

Methods: The RAND/UCLA Appropriateness Method was used to combine the best available scientific evidence with the collective judgement of experts to develop quality indicators for Barrett's endotherapy in four subgroups: pre-endoscopy, intraprocedure (resection and ablation) and postendoscopy. International experts, including gastroenterologists, surgeons, BE pathologist, clinical nurse specialist and patient representative, participated in a three-round process to develop 15 QIs that fulfilled the RAND/UCLA definition of appropriateness.

Results: 17 experts participated in round 1 and 20 in round 2. Of the 24 proposed QIs in round 1, 20 were ranked as appropriate (put through to round 2) and 4 as uncertain (discarded). At the end of round 2, a final list of 15 QIs were scored as appropriate.

Conclusions: This UK national consensus project has successfully developed QIs for patients undergoing Barrett's endotherapy. These QIs can be used by service providers to ensure that all patients with BE neoplasia receive uniform and high-quality care.

Keywords: Barrett’s Oesophagus; Endoscopic Mucosal Resection (EMR); Endoscopic Submucosal Dissection (ESD); Radio Frequency Ablation (RFA); endoscopy.

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Conflict of interest statement

Competing interests: None declared.

Figures

**Figure 1**
RAND/UCLA Appropriateness Method (RAM): summary. EET, endoscopic eradication therapy.

See this image and copyright information in PMC

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Factors influencing participation in randomised clinical trials among patients with early Barrett's neoplasia: a multicentre interview study.
Peerally MF, Jackson C, Bhandari P, Ragunath K, Barr H, Stokes C, Haidry R, Lovat LB, Smart H, De Caestecker J. Peerally MF, et al. BMJ Open. 2023 Jan 6;13(1):e064117. doi: 10.1136/bmjopen-2022-064117. BMJ Open. 2023. PMID: 36609332 Free PMC article.

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Quality indicators for Barrett's endotherapy (QBET): UK consensus statements for patients undergoing endoscopic therapy for Barrett's neoplasia

Affiliations

Quality indicators for Barrett's endotherapy (QBET): UK consensus statements for patients undergoing endoscopic therapy for Barrett's neoplasia

Authors

Affiliations

Abstract

Conflict of interest statement

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