ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2009
Controversies in ulcerative colitis: a survey comparing decision making of experts versus community gastroenterologists.
Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
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Who cites it
26 citing papers in PubMed, 60 citations in OpenAlex.
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- IBD barriers across the continents: a continent-specific analysis - Australasia.Therapeutic advances in gastroenterology · 2023Review
- Heterogeneity in pharmacological treatment and outcomes in Crohn's disease patients in Catalonia: a population-based observational study.Annals of medicine · 2022Observational
- Perception of Cancer Risk and Management Practice for Colitis-associated Dysplasia Is Influenced by Colonoscopy Experience and Workplace Affiliation: Results of an International Clinician Survey.Journal of Crohn's & colitis · 2022Article
- Article
- Acute Severe Colitis: The Need for Joint Management between Gastroenterologists and Surgeons.Clinics in colon and rectal surgery · 2022Review
- The Reliability of Patient Self-reported Utilization in an Inflammatory Bowel Diseases Learning Health System.Crohn's & colitis 360 · 2021Article
- Guideline recommendations for treatment of patients with inflammatory bowel diseases are not implemented in clinical practice-results of a non-representative survey.International journal of colorectal disease · 2019Article
- Quality improvement in healthcare for patients with inflammatory bowel disease.Translational pediatrics · 2019Review
- Timing of surgery in ulcerative colitis in the biologic therapy era-the patient's perspective.International journal of colorectal disease · 2018Article
- Quality of care in inflammatory bowel diseases: What is the best way to better outcomes?World journal of gastroenterology · 2018Review
- Quality indicators in inflammatory bowel disease.Intestinal research · 2018Review
- Quality Improvement Initiatives in Inflammatory Bowel Disease.Current gastroenterology reports · 2017Review
- Combination of corticosteroids and 5-aminosalicylates or corticosteroids alone for patients with moderate-severe active ulcerative colitis: A global survey of physicians' practice.World journal of gastroenterology · 2017Observational
- Variation in Care of Inflammatory Bowel Diseases Patients in Crohn's and Colitis Foundation of America Partners: Role of Gastroenterologist Practice Setting in Disease Outcomes and Quality Process Measures.Inflammatory bowel diseases · 2016Article
- Implementing quality measures for inflammatory bowel disease.Current gastroenterology reports · 2015Review
- Approaches to improve quality of care in inflammatory bowel diseases.World journal of gastroenterology · 2014Review
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Authors and funding
8 authors at 5 institutions in 1 country.
Funding
Abstract
BACKGROUND &
aimsDespite the development of consensus guidelines in ulcerative colitis (UC), there remain several areas of uncertainty in the everyday management of this incompletely understood disease. We performed a national vignette survey to measure variations in decision-making in areas of controversy.
methodsWe constructed a survey with 3 vignettes to measure decision-making in 4 areas of controversy in UC: (1) dysplasia management, (2) mesalamine dosing, (3) diagnostic testing for underlying Crohn's disease, and (4) treatment of steroid-refractory inpatient UC. We compared responses between a group of community gastroenterologists and UC experts.
resultsWe received 192 responses (36% response). Compared with community gastroenterologists, UC experts were more likely to endorse colectomy for both unifocal and multifocal low-grade dysplasia, use narrow band imaging and chromoendoscopy for surveillance colonoscopy, use high-dose mesalamine for inducing remission, use long-term mesalamine for cancer chemoprevention, order computed tomography enterography to evaluate for Crohn's disease, and to have a lower threshold to call for surgery consultation in steroid-refractory UC. There was little agreement regarding the optimal frequency of surveillance colonoscopy, even among experts. Most respondents favored using infliximab over cyclosporine in steroid-refractory UC.
conclusionsCommunity gastroenterologists and UC experts vary dramatically in their approach to many areas of uncertainty in UC. The only area of consensus between groups is the use of infliximab over cyclosporine in steroid-refractory UC, itself a controversial decision. These data suggest that current practice patterns are highly disparate and focus attention on specific areas of disconnect that should be further investigated.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.