Pediatric Endoscopy Quality Improvement Network Pediatric Endoscopy Reporting Elements

Walsh, Catharine M.; Lightdale, Jenifer R.; Fishman, Douglas S.; Furlano, Raoul I.; Mamula, Petar; Gillett, Peter M.; Narula, Priya; Hojsak, Iva; Oliva, Salvatore; Homan, Matjaž; Riley, Matthew R.; Huynh, Hien Q.; Rosh, Joel R.; Jacobson, Kevan; Tavares, Marta; Leibowitz, Ian; Utterson, Elizabeth C.; Croft, Nicholas M.; Mack, David R.; Brill, Herbert; Liu, Quin Y.; Bontems, Patrick; Lerner, Diana; Amil‐Dias, Jorge; Krämer, Robert; Otley, Anthony; Ambartsumyan, Lusine; Connan, Veronik; McCreath, Graham A.; Thomson, Mike

doi:10.1097/mpg.0000000000003266

Cited by 9 publications

(6 citation statements)

References 96 publications

(144 reference statements)

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“…Another strength in this study is the objective confirmation of extent of procedure rather than just relying on the endoscopist’s report, in contrast to previous studies which have not reported on this. PEnQuIN has recently recommended that confirmation of extent of procedure be documented in all colonoscopy reports (12).…”

Section: Discussionmentioning

confidence: 99%

Characterization of Colonoscopies in Preschool Children

Bolia

Thapar

Withers

et al. 2023

Journal of Pediatric Gastroenterology &Amp; Nutrition

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Objectives: The indications, diagnostic yield, complications, and cecal and ileal intubation rates (CIR and IIR) for colonoscopies in children aged <6 years, denoted preschoolers, is unclear since there is limited information for this group. We aimed to describe the above parameters in our cohort of preschoolers undergoing a colonoscopy. Methods: Retrospective review of all colonoscopies in a tertiary pediatric hospital between December 1, 2014 to December 31, 2020 was undertaken. Demographic factors, indication for colonoscopy, extent of colonoscopy, CIR, IIR, and histologic findings were noted. Preschoolers were further subdivided into those aged <2 years, and those aged 2 to <6 years. Results: One thousand six hundred seventy-one total colonoscopies were performed, of which 13% (n = 219) were in preschoolers with median age 3.9 (range 0.3–5.9) years. Most common indications in preschoolers were rectal bleeding 35% (n = 78), inflammatory bowel disease 24% (n = 53), diarrhea 13% (n = 30), iron-deficiency anemia 11% (n = 25), and abdominal pain 7% (n = 16). IIR and CIR were lower in preschoolers compared to older children, 81% vs 92% (P = 0.0001), and 93% vs 96.4% (P = 0.02), respectively, and even lower in those aged <2 years, 48.1% IIR (P = 0.0001) and 85.1% CIR. Juvenile polyps, 31% (n = 27), were the most common positive finding in preschool children. Conclusion: Rectal bleeding was the most common indication and juvenile polyps the most common finding at colonoscopy in preschoolers. A high IIR is achievable in young children but rates are increasingly lower the younger the child.

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Section: Discussionmentioning

confidence: 99%

Characterization of Colonoscopies in Preschool Children

Bolia

Thapar

Withers

et al. 2023

Journal of Pediatric Gastroenterology &Amp; Nutrition

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“…Incomplete ileocolonoscopy in children can lead to missed diagnoses and the potential need for repeat examinations and/or alternative investigations. The PEn-QuIN working group did identify documentation of ''extent of examination'' and ''reason for premature termination of procedure'' as key endoscopy reporting elements, as these help to better elucidate factors affecting the performance of complete pediatric ileocolonoscopy (74).…”

Section: Discussionmentioning

confidence: 99%

Pediatric Endoscopy Quality Improvement Network Quality Standards and Indicators for Pediatric Endoscopists and Endoscopists in Training

Walsh

Lightdale

Leibowitz

et al. 2021

J. pediatr. gastroenterol. nutr.

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Introduction: High-quality pediatric endoscopy requires reliable performance of procedures by competent individual providers who consistently uphold all standards determined to assure optimal patient outcomes. Establishing consensus expectations for ongoing monitoring and assessment of individual pediatric endoscopists is a method for confirming the highest possible quality of care for such procedures worldwide. We aim to provide guidance to define and measure quality of endoscopic care for children. Methods: With support from the North American and European Societies of Pediatric Gastroenterology Hepatology and Nutrition (NASPGHAN and ESPGHAN), an international working group of the Pediatric Endoscopy Quality Improvement Network (PEnQuIN) used the methodological strategy of the Appraisal of Guidelines for REsearch and Evaluation (AGREE) II instrument to develop standards and indicators relevant for assessing the quality of endoscopists. Consensus was sought via an iterative online Delphi process and finalized at an in-person conference. The quality of evidence and strength of recommendations were rated according to the GRADE (Grading of Recommendation Assessment, Development, and Evaluation) approach.Results: The PEnQuIN working group achieved consensus on 6 standards that all providers who perform pediatric endoscopy should uphold and 2 standards for pediatric endoscopists in training, with 7 corresponding indicators that can be used to identify high-quality endoscopists. Additionally, these can inform continuous quality improvement at the provider level. Minimum targets for defining high-quality pediatric ileocolonoscopy were set for 2 key indicators: cecal intubation rate (!90%) and terminal ileal intubation rate (!85%). Discussion: It is recommended that all individual providers performing or training to perform pediatric endoscopy initiate and engage with these international endoscopist-related standards and indicators developed by PEnQuIN.

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“…A phase 2/3 trial among the young and old adults of the UK revealed that, in both the low dose group and the standard dose group, the ≥70 years age group resulted in low anti-spike IgG responses for ChAdOx1 nCoV-19 vaccine compared to the 18–55 years and 56–69 years age groups (3565 AU/mL, 6439 AU/mL, 4553 AU/mL in low dose and 4156 AU/mL, 9807 AU/mL, 5496 AU/mL in standard dose group, respectively) [ 80 ]. A contradictory observation was made by a clinical trial on the immunogenicity of Pfizer-BioNTech’s BNT162b2 in the 18–55 years and 65–85 years age groups, wherein comparable dose-dependent SARS-CoV-2–neutralizing GMTs were shown by both the age groups [ 81 ].…”

Section: Aging and Immunosenescence In The Context Of Vaccine Responsesmentioning

confidence: 99%

Aging and Microbiome in the Modulation of Vaccine Efficacy

Kumar¹,

James²,

Kumawat³

et al. 2022

Biomedicines

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From infancy through to old age, the microbiome plays an important role in modulating the host-immune system. As we age, our immune system and our gut microbiota change significantly in composition and function, which is linked to an increased vulnerability to infectious diseases and a decrease in vaccine responses. Our microbiome remains largely stable throughout adulthood; however, aging causes a major shift in the composition and function of the gut microbiome, as well as a decrease in diversity. Considering the critical role of the gut microbiome in the host-immune system, it is important to address, prevent, and ameliorate age-related dysbiosis, which could be an effective strategy for preventing/restoring functional deficits in immune responses as we grow older. Several factors, such as the host’s genetics and nutritional state, along with the gut microbiome, can influence vaccine efficacy or reaction. Emerging evidence suggests that the microbiome could be a significant determinant of vaccine immunity. Physiological mechanisms such as senescence, or the steady loss of cellular functions, which affect the aging process and vaccination responses, have yet to be comprehended. Recent studies on several COVID-19 vaccines worldwide have provided a considerable amount of data to support the hypothesis that aging plays a crucial role in modulating COVID-19 vaccination efficacy across different populations.

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Pediatric Endoscopy Quality Improvement Network Pediatric Endoscopy Reporting Elements

Cited by 9 publications

References 96 publications

Characterization of Colonoscopies in Preschool Children

Characterization of Colonoscopies in Preschool Children

Pediatric Endoscopy Quality Improvement Network Quality Standards and Indicators for Pediatric Endoscopists and Endoscopists in Training

Aging and Microbiome in the Modulation of Vaccine Efficacy

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