دورية أكاديمية
Planning management for complex colorectal polyps: a qualitative assessment of factors influencing decision-making among colonoscopists
| العنوان: | Planning management for complex colorectal polyps: a qualitative assessment of factors influencing decision-making among colonoscopists |
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| المؤلفون: | Parker, Jody, Semedo, Lenira, Shenbagaraj, Lavanya, Torkington, Jared, Dolwani, Sunil |
| بيانات النشر: | BMJ Publishing Group |
| سنة النشر: | 2023 |
| المجموعة: | Cardiff University: ORCA (Online Research @ Cardiff) |
| الوصف: | Objective: Endoscopic therapy is the recommended primary treatment for most complex colorectal polyps, but high colonic resection rates are reported. The aim of this qualitative study was to understand and compare between specialities, the clinical and non-clinical factors influencing decision making when planning management. Design: Semi-structured interviews were performed among colonoscopists across the UK. Interviews were conducted virtually and transcribed verbatim. Complex polyps were defined as lesions requiring further management planning rather than those treatable at the time of endoscopy. A thematic analysis was performed. Findings were coded to identify themes and reported narratively. Results: Twenty colonoscopists were interviewed. Four major themes were identified including gathering information regarding the patient and their polyp, aids to decision making, barriers in achieving optimal management and improving services. Participants advocated endoscopic management where possible. Factors such as younger age, suspicion of malignancy, right colon or difficult polyp location lead towards surgical intervention and were similar between surgical and medical specialties. Availability of expertise, timely endoscopy and challenges in referral pathways were reported barriers to optimal management. Experiences of team decision-making strategies were positive and advocated in improving complex polyp management. Recommendations based on these findings to improve complex polyp management are provided. Conclusion: The increasing recognition of complex colorectal polyps requires consistency in decision making and access to a full range of treatment options. Colonoscopists advocated the availability of clinical expertise, timely treatment and education in avoiding surgical intervention and providing good patient outcomes. Team decision-making strategies for complex polyps may provide an opportunity to coordinate and improve these issues. |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/pdf |
| اللغة: | English |
| العلاقة: | https://orca.cardiff.ac.uk/id/eprint/160114/1/Parker,Semedo%20et%20al_2023.pdfTest; Parker, Jody https://orca.cardiff.ac.uk/view/cardiffauthors/A035621W.htmlTest, Semedo, Lenira, Shenbagaraj, Lavanya, Torkington, Jared https://orca.cardiff.ac.uk/view/cardiffauthors/A215102M.htmlTest and Dolwani, Sunil https://orca.cardiff.ac.uk/view/cardiffauthors/A031553M.htmlTest orcid:0000-0002-3113-5472 orcid:0000-0002-3113-5472 2023. Planning management for complex colorectal polyps: a qualitative assessment of factors influencing decision-making among colonoscopists. BMJ Open Gastroenterology 10 , e0010. 10.1136/bmjgast-2022-001097 https://doi.org/10.1136/bmjgast-2022-001097Test file https://orca.cardiff.ac.uk/id/eprint/160114/1/Parker,Semedo%20et%20al_2023.pdfTest |
| DOI: | 10.1136/bmjgast-2022-001097 |
| الإتاحة: | https://doi.org/10.1136/bmjgast-2022-001097Test https://orca.cardiff.ac.uk/id/eprint/160114Test/ https://orca.cardiff.ac.uk/id/eprint/160114/1/Parker,Semedo%20et%20al_2023.pdfTest |
| حقوق: | cc_by_nc_4_0 |
| رقم الانضمام: | edsbas.2498A4E5 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1136/bmjgast-2022-001097 |
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