1.Risk Stratification in Cancer Patients with Acute Upper Gastrointestinal Bleeding: Comparison of Glasgow-Blatchford, Rockall and AIMS65, and Development of a New Scoring System
Matheus Cavalcante FRANCO ; Sunguk JANG ; Bruno da Costa MARTINS ; Tyler STEVENS ; Vipul JAIRATH ; Rocio LOPEZ ; John J. VARGO ; Alan BARKUN ; Fauze MALUF-FILHO
Clinical Endoscopy 2022;55(2):240-247
Background/Aims:
Few studies have measured the accuracy of prognostic scores for upper gastrointestinal bleeding (UGIB) among cancer patients. Thereby, we compared the prognostic scores for predicting major outcomes in cancer patients with UGIB. Secondarily, we developed a new model to detect patients who might require hemostatic care.
Methods:
A prospective research was performed in a tertiary hospital by enrolling cancer patients admitted with UGIB. Clinical and endoscopic findings were obtained through a prospective database. Multiple logistic regression analysis was performed to gauge the power of each score.
Results:
From April 2015 to May 2016, 243 patients met the inclusion criteria. The AIMS65 (area under the curve [AUC] 0.85) best predicted intensive care unit admission, while the Glasgow-Blatchford score best predicted blood transfusion (AUC 0.82) and the low-risk group (AUC 0.92). All scores failed to predict hemostatic therapy and rebleeding. The new score was superior (AUC 0.74) in predicting hemostatic therapy. The AIMS65 (AUC 0.84) best predicted in-hospital mortality.
Conclusions
The scoring systems for prognostication were validated in the group of cancer patients with UGIB. A new score was developed to predict hemostatic therapy. Following this result, future prospective research should be performed to validate the new score.
2.Impact of COVID-19 on Endoscopy Training: Perspectives from a Global Survey of Program Directors and Endoscopy Trainers
Shivakumar VIGNESH ; Amna Subhan BUTT ; Mohamed ALBORAIE ; Bruno Costa MARTINS ; Alejandro PISCOYA ; Quang Trung TRAN ; Damien Tan Meng YEW ; Shahriyar GHAZANFAR ; Pezhman ALAVINEJAD ; Edna KAMAU ; Ajay M VERMA ; Robin B MENDELSOHN ; Christopher KHOR ; Alan MOSS ; David Wei Chih LIAO ; Christopher S HUANG ; Franklin C TSAI
Clinical Endoscopy 2021;54(5):678-687
Background/Aims:
The coronavirus disease of 2019 (COVID-19) pandemic has impacted the training of medical trainees internationally. The aim of this study was to assess the global impact of COVID-19 on endoscopy training from the perspective of endoscopy trainers and to identify strategies implemented to mitigate the impact on trainee education.
Methods:
Teaching faculty of gastroenterology (GI) training programs globally were invited to complete a 36-question web-based survey to report the characteristics of their training programs and the impact of COVID-19 on various aspects of endoscopy training, including what factors decisions were based on.
Results:
The survey response rate was 52.6% (305 out of 580 individuals); 92.8% reported a negative impact on endoscopy training, with suspension of elective procedures (77.1%) being the most detrimental factor. Geographic variations were noted, with European programs reporting the lowest percentage of trainee participation in procedures. A higher proportion of trainees in the Americas were allowed to continue performing procedures, and trainers from the Americas reported receiving the greatest support for endoscopy teaching.
Conclusions
This study demonstrated that the COVID-19 pandemic has had a significant negative impact on GI endoscopy training internationally, as reported by endoscopy trainers. Focus-optimizing endoscopy training and assessment of competencies are necessary to ensure adequate endoscopy training.
3.Impact of COVID-19 on Endoscopy Training: Perspectives from a Global Survey of Program Directors and Endoscopy Trainers
Shivakumar VIGNESH ; Amna Subhan BUTT ; Mohamed ALBORAIE ; Bruno Costa MARTINS ; Alejandro PISCOYA ; Quang Trung TRAN ; Damien Tan Meng YEW ; Shahriyar GHAZANFAR ; Pezhman ALAVINEJAD ; Edna KAMAU ; Ajay M VERMA ; Robin B MENDELSOHN ; Christopher KHOR ; Alan MOSS ; David Wei Chih LIAO ; Christopher S HUANG ; Franklin C TSAI
Clinical Endoscopy 2021;54(5):678-687
Background/Aims:
The coronavirus disease of 2019 (COVID-19) pandemic has impacted the training of medical trainees internationally. The aim of this study was to assess the global impact of COVID-19 on endoscopy training from the perspective of endoscopy trainers and to identify strategies implemented to mitigate the impact on trainee education.
Methods:
Teaching faculty of gastroenterology (GI) training programs globally were invited to complete a 36-question web-based survey to report the characteristics of their training programs and the impact of COVID-19 on various aspects of endoscopy training, including what factors decisions were based on.
Results:
The survey response rate was 52.6% (305 out of 580 individuals); 92.8% reported a negative impact on endoscopy training, with suspension of elective procedures (77.1%) being the most detrimental factor. Geographic variations were noted, with European programs reporting the lowest percentage of trainee participation in procedures. A higher proportion of trainees in the Americas were allowed to continue performing procedures, and trainers from the Americas reported receiving the greatest support for endoscopy teaching.
Conclusions
This study demonstrated that the COVID-19 pandemic has had a significant negative impact on GI endoscopy training internationally, as reported by endoscopy trainers. Focus-optimizing endoscopy training and assessment of competencies are necessary to ensure adequate endoscopy training.