Recovery of endoscopy services in the era of COVID-19: Recommendations from an international Delphi consensus

Theodor Bilharz Research Institute

Bibliographic Information

Authors: Bhandari P.; Subramaniam S.; Bourke M.J.; Alkandari A.; Chiu P.W.Y.; Brown J.F.; Keswani R.N.; Bisschops R.; Hassan C.; Raju G.S.; Muthusamy V.R.; Sethi A.; May G.R.; Albéniz E.; Bruno M.; Kaminski M.F.; Alkhatry M.; Almadi M.; Ibrahim M.; Emura F.; Moura E.; Navarrete C.; Wulfson A.; Khor C.; Ponnudurai R.; Inoue H.; Saito Y.; Yahagi N.; Kashin S.; Nikonov E.; Yu H.; Maydeo A.P.; Reddy D.N.; Wallace M.B.; Pochapin M.B.; Rösch T.; Sharma P.; Repici A.

Journal: Gut

Publisher: BMJ Publishing Group

Publication Date: 14 August 2020

Volume / Issue: Volume 69 / Issue 11

Pages: 1915–1924

ISSN: 175749

DOI: 10.1136/gutjnl-2020-322329

Scopus: View on Scopus

PubMed: 32816921

Document Type: Review

Access: All Open Access; Bronze Open Access; Green Open Access

Authors and Affiliations

Bhandari P., Department of Gastroenterology, Portsmouth Hospitals University NHS Trust, Portsmouth, PO6 3LY, United Kingdom, School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, Hampshire, United Kingdom; Subramaniam S., Department of Gastroenterology, Portsmouth Hospitals University NHS Trust, Portsmouth, PO6 3LY, United Kingdom; Bourke M.J., Department of Gastroenterology and Hepatology, Westmead Hospital, Westmead, NSW, Australia; Alkandari A., Department of Gastroenterology, Al Jahra Hospital, Kuwait City, Al Jahra, Kuwait; Chiu P.W.Y., Department of Surgery, Chinese University of Hong Kong, Hong Kong, Hong Kong; Brown J.F., School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, Hampshire, United Kingdom; Keswani R.N., Department of Gastroenterology and Hepatology, Northwestern University, Chicago, IL, United States; Bisschops R., Department of Gastroenterology, University Hospital Gasthuisberg, Leuven, Vlaams Brabant, Belgium; Hassan C., Gastroenterology Unit, Nuovo Regina Margherita Hospital, Rome, Italy; Raju G.S., Department of Gastroenterology, Hepatology and Nutrition, Universidad of Texas MD Anderson Cancer Center, Houston, TX, United States; Muthusamy V.R., Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA, United States; Sethi A., Division of Digestive and Liver Diseases, Columbia University Medical Center, New York, NY, United States; May G.R., Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada; Albéniz E., Gastroenterology Department, Complejo Hospitalario de Navarra, Pamplona, Spain; Bruno M., Department of Gastroenterology and Hepatology, Erasmus Medical Centre, Rotterdam, Netherlands; Kaminski M.F., Department of Gastroenterology, Hepatology and Oncology, Centre for Postgraduate Medical Education, Warsaw, Poland, Department of Gastroenterological Oncology, Maria Sklodowska-Curie Memorial Cancer Centre, Instytute of Oncology, Warsaw, Poland; Alkhatry M., Department of Gastroenterology, Obaidulla Hospital, Ras Al Khaimah, United Arab Emirates; Almadi M., Department of Gastroenterology, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia, Riyadh, Saudi Arabia; Ibrahim M., Department of Gastroenterology and Hepatology, Theodor Bilharz Research Institute, Cairo, Giza, Egypt; Emura F., Gastroenterology Division, Universidad de la Sabana, Chia, Colombia, Department of Advanced GI Endoscopy, EmuraCenter LatinoAmerica, Bogota, Colombia; Moura E., Department of Gastroenterology, University of Sao Paulo Medical School, Sao Paulo, Sao Paulo, Brazil; Navarrete C., Department of Surgery, Clinica Santa Maria, Santiago, Chile; Wulfson A., Department of Gastroenterology, Hospital de Emergencias Dr Clemente Alvarez, Rosario, Rosario, Argentina; Khor C., Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore, Singapore; Ponnudurai R., Department of Gastroenterology, Prince Court Medical Centre, Kuala Lumpur, Malaysia; Inoue H., Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan; Saito Y., Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan; Yahagi N., Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan, Cancer Center, Keio University, Tokyo, Japan; Kashin S., Department of Endoscopy, Yaroslavl Regional Cancer Hospital, Yaroslavl, Russian Federation; Nikonov E., Department of Gastroenterology, Pirogov Russian National Research Medical University, Moscow, Russian Federation; Yu H., Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China; Maydeo A.P., Department of Surgery, Baldota Institute of Digestive Sciences, Global Hospitals, Mumbai, India; Reddy D.N., Asian Healthcare Foundation, Asian Institute of Gastroenterology, Hyderabad, Andhra Pradesh, India; Wallace M.B., Division of Gastroenterology, Mayo Clinic, Jacksonville, FL, United States; Pochapin M.B., Division of Gastroenterology, NYU Langone Medical Center, New York, NY, United States; Rösch T., Department of Interdisciplinary Endoscopy, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Sharma P., Endoscopy Unit, Veteran Affairs Medical Center and University of Kansas, Kansas City, KS, United States; Repici A., Gastroenterology and Endoscopy Unit, Istituto Clinico Humanitas, Milan, Italy

Abstract

The COVID-19 pandemic has had a profound impact on provision of endoscopy services globally as staff and real estate were repurposed. As we begin to recover from the pandemic, a cohesive international approach is needed, and guidance on how to resume endoscopy services safely to avoid unintended harm from diagnostic delays. The aim of these guidelines is to provide consensus recommendations that clinicians can use to facilitate the swift and safe resumption of endoscopy services. An evidence-based literature review was carried out on the various strategies used globally to manage endoscopy during the COVID-19 pandemic and control infection. A modified Delphi process involving international endoscopy experts was used to agree on the consensus statements. A threshold of 80% agreement was used to establish consensus for each statement. 27 of 30 statements achieved consensus after two rounds of voting by 34 experts. The statements were categorised as pre-endoscopy, during endoscopy and postendoscopy addressing relevant areas of practice, such as screening, personal protective equipment, appropriate environments for endoscopy and infection control precautions, particularly in areas of high disease prevalence. Recommendations for testing of patients and for healthcare workers, appropriate locations of donning and doffing areas and social distancing measures before endoscopy are unique and not dealt with by any other guidelines. This international consensus using a modified Delphi method to produce a series of best practice recommendations to aid the safe resumption of endoscopy services globally in the era of COVID-19. ©

Keywords

endoscopy; infectious disease; Consensus; Coronavirus Infections; Cross Infection; Delphi Technique; Endoscopy, Digestive System; Female; Follow-Up Studies; Humans; Incidence; Internationality; Male; Occupational Health; Pandemics; Patient Safety; Pneumonia, Viral; Practice Guidelines as Topic; Risk Assessment; Time Factors; United States; clinical practice; cohort analysis; coronavirus disease 2019; digestive tract endoscopy; evidence based practice; health care personnel; human; infection control; pandemic; practice guideline; priority journal; Review; safety procedure; social distancing; Coronavirus infection; Delphi study; follow up; international cooperation; procedures; time factor; virus pneumonia

Citation Information

Scopus Citations: 33

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