Evidence map›Paper›PMID 36725765›Full record

ArticleDigestive diseases and sciences2023

Successful Design and Implementation of a POEM Program for Achalasia in an Integrated Healthcare System.

Lawrence Jun Leung, Gene K Ma, Jeffrey K Lee, Norio Fukami, Howard Chang, Jonathan Svahn, Ming-Ming Xu, Steven Lam, Amita Risbud, Terry L Jue

Open access · bronzeAbstract read
In one paragraph

Article in Digestive diseases and sciences, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
0.8field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it, 3 citations in OpenAlex.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 1 country.

Lawrence Jun LeungDepartment of Internal Medicine, Kaiser Permanente San Francisco, San Francisco, CA, USA. Lawrence.j.leung@kp.org.ORCID http://orcid.org/0000-0001-6019-0385
Gene K MaDepartment of Gastroenterology, Kaiser Permanente San Jose, San Jose, CA, USA.
Jeffrey K LeeDepartment of Gastroenterology, Kaiser Permanente San Francisco, San Francisco, CA, USA.
Norio FukamiDivision of Gastroenterology and Hepatology, Mayo Clinic Arizona, Scottsdale, AZ, USA.
Howard ChangDepartment of Gastroenterology, Kaiser Permanente Oakland, Oakland, CA, USA.
Jonathan SvahnDepartment of Surgery, Kaiser Permanente Oakland, Oakland, CA, USA.
Ming-Ming XuDepartment of Gastroenterology, Kaiser Permanente West LA, Los Angeles, CA, USA.
Steven LamDepartment of Internal Medicine, Kaiser Permanente San Francisco, San Francisco, CA, USA.
Amita RisbudDepartment of Internal Medicine, Kaiser Permanente San Francisco, San Francisco, CA, USA.
Terry L JueDepartment of Gastroenterology, Kaiser Permanente San Francisco, San Francisco, CA, USA.
Kaiser Permanente San Francisco Medical Center · USKaiser Permanente Oakland Medical Center · USKaiser Permanente San Jose Medical Center · USKaiser Permanente West Los Angeles Medical Center · USMayo Clinic in Arizona · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPer Oral Endoscopic Myotomy (POEM) is a minimally invasive treatment for achalasia with results comparable to laparoscopic Heller myotomy (LHM). Studies have described the development of proficiency for endoscopists learning to perform POEM, and societies have defined educational and technical objectives for advanced endoscopy fellows in training. However, there is limited guidance on the organizational strategy and educational plan necessary to develop an achalasia service with POEM expertise.

aimsWe aim to outline the steps for design and implementation of a successful POEM program.

methodsWe reported our experience developing a multi-disciplinary clinical program for POEM and the steps taken to achieve procedural proficiency. We also reported our technical success (successful tunneling into the gastric cardia and myotomy of LES muscle fibers) and clinical success (post-procedure Eckardt score ≤ 3) at 3-6 months and 12 months post-procedure. Adverse events were classified per the ASGE lexicon for endoscopic adverse events.

resultsAfter creating a multi-disciplinary clinical program for achalasia and completing procedural proficiency for POEM, our technical success rate was 100% and clinical success rate 90% for the first 41 patients. One adverse event (2.4%) occurred, moderate in severity per the American Society of Gastrointestinal Endoscopy (ASGE) lexicon for adverse endoscopic events.

conclusionIn this study, we outlined the steps involved to establish a POEM service in a large integrated healthcare system. Prior competency in interventional endoscopy, procedural training models, POEM observation and education, proctorship, and interdisciplinary patient care are recommended.

Indexed as

Esophageal AchalasiaHeller MyotomyMyotomyNatural Orifice Endoscopic SurgeryEndoscopy, GastrointestinalEsophageal Sphincter, LowerHumansTreatment OutcomeAchalasiaCompetencyImplementationIntegrated healthcare systemPeroral endoscopic myotomy

Identifiers

PMID36725765
PMCPMC9891752
OpenAlexW4318932787

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.