🧵1/6.🚨 New from the British Society of Gastroenterology:.We analysed all UK colonoscopies from the National Endoscopy Database (2019–2020). That’s over 592,000 procedures. Findings below 👇. (📄 Free article link (limited time): .

RT @GIE_Journal: Online now in GIE’s Articles in Press: "British Society of Gastroenterology national evaluation of colonoscopy quality: fi….

6/6.🔚 TL;DR:.UK colonoscopy quality is improving — but variation remains. Volume matters: Low-volume endoscopists = lower quality. Longer withdrawal times = more polyps found. It's time to tackle poor quality colonoscopy. @JAG_Endoscopy @BritSocGastro @ACPGBI @GIE_Journal.

5/6.⏱️ Withdrawal time = quality. Endoscopists who took longer on the withdrawal phase found more (and larger) polyps:. 11 min = nearly 2x more likely to detect polyps vs <6 min. Case-mix adjusted results for large polyps (≥10mm) seen 👇

4/6.👨‍⚕️ Specialty also played a role. Surgeons had lower PDR and CIR, and more patient discomfort — but those doing ≥200/year performed almost as well as gastroenterologists. 💡 It’s not about the specialty — it’s about volume & experience.

3/6.🔍 Endoscopist volume matters. Those performing <100 colonoscopies/year had much worse outcomes:. Only 46% met all key performance indicators (vs 69% for >100/year). Lower PDR. More incomplete procedures. Higher patient discomfort.

2/6.✅ Quality has improved since the last UK audit (2011):.Caecal intubation rate: 93.5% (from 92.3%). Polyp detection rate: 37.3% (from 32.1%). Moderate/severe discomfort: halved (4.8% vs 9.8%). But 36% of endoscopists still didn’t meet these 3 BSG minimum standards.

RT @AlastairHogg1: It's that time of year again. our hugely anticipated clinical fellowship applications are open! . 80:20 job split, Emer….

RT @alex_ford12399: Our opinion piece discussing the case for rationalising the use of diagnostic gastrointestinal endoscopy, based on impo….

RT @KralJan: 🚨 Get ready for #ESGEDays2025 in Barcelona! 🇪🇸 . 🗓️ *Save the dates!*.📅 Sept 17, 2024: Call for Abstracts opens! 📝 .📅 Nov 5,….

RT @Gut_BMJ: #GUTBlog by @davidbeaton87 on "Diagnostic yield from symptomatic gastroscopy in the UK: BSG analysis using data from the Natio….

Thank you for reading! Please feel free to ask any questions. A special thanks to our reviewers for their valuable insights and improvements, and to co-authors (@Rutter_Matt, Nigel Trudgill & Linda Sharp) and @JAG_Endoscopy. #GIbleeds #Endoscopy #Research.

The answer is 'possibly.' Most endoscopists perform very low volumes of UGIB therapy annually. Given these are complex procedures this should raise alarm bells…but we can’t assess outcomes using this dataset.

What about volume? We know it's crucial for endoscopy quality. But in the UK, based on NCEPOD's 24-hour GI bleed coverage recommendations, have we sacrificed quality to cover these rotas?.

Why does this matter? These factors aren’t in current pre-endoscopy risk scores (Rockall and GBS in the UK). Understanding them can improve predictions and urgent care decisions, like determining if overnight intervention is needed.

🔹The combination of haematemesis and melaena was a MUCH better predictor of endotherapy need than each symptom alone. 🔹Males had a higher likelihood of requiring therapy than females. 🔹Those under 40 were half as likely to need endotherapy compared to other age groups.

🔑background info: .🔹Over 47k OGDs analysed .🔹~80% UK endoscopy sites uploading over the year 🔹Endotherapy performed in ~20% of in-patient procedures, similar to @BritSocGastro UGIB audit results .🔹Median therapeutic OGDs annually by endoscopist: 3 (IQR 2-7) . More results👇.

Thanks to @FrontGastro_BMJ for publishing our📜on OGDs for UGIBs. 🔑Findings: .🔹Patients with both haematemesis & melaena were 3x to need endotherapy than each symptom alone .🔹UK endoscopists perform few therapeutic OGDs annually. More insights: & 👇.

RT @laura_tee_mdgi: Here is my full review of the most impactful papers in IBD so far this year. SEQUENCE study compares Risankizumab (RIS….

Amazing study @DrJamieC! Hoping to see feedback emails soon.