Studies across medical disciplines have shown gaps in the care recommended in evidence based guidelines and the care actually delivered. Quality improvement projects using systematic audit and feedback interventions s...Studies across medical disciplines have shown gaps in the care recommended in evidence based guidelines and the care actually delivered. Quality improvement projects using systematic audit and feedback interventions such as quality measures, will become increasingly important tools to address these gaps in care. These gaps are also apparent in the care of patients with inflammatory bowel disease. Multiple organizations, including the American Gastroenterology Association and the Crohn’s and Colitis Foundation of America, have developed programs designed to implement quality measures to improve the care of inflammatory bowel disease (IBD) patients. Early results show promise of improving quality, but numerous barriers remain. Gastroenterologists need to be aware of these processes to provide the highest care possible to patients with IBD. We review the existing literature on approaches to quality improvement and their potential application and barriers when applied to IBD care.展开更多
Traditionally,patients with inflammatory bowel disease(IBD) have been thought to be at increased risk of developing colitis-associated colorectal cancer.Although there are recent data suggesting that rates of colitisa...Traditionally,patients with inflammatory bowel disease(IBD) have been thought to be at increased risk of developing colitis-associated colorectal cancer.Although there are recent data suggesting that rates of colitisassociated cancer in IBD patients is declining,current guidelines still recommend regular dysplasia surveillance for early detection and prevention of neoplasia in patients with IBD.White-light endoscopy with random biopsies has been the traditional approach for dysplasia detection;however,newer technologies and approaches have emerged.One method,dye-based chromoendoscopy,has the potential to detect more dysplasia.However,longitudinal data to showing a benefit in morbidity or mortality from the use of chromoendoscopy are still lacking.Many societies have included recommendation on the use of chromoendoscopy with targeted biopsies as a method of surveillance for colitis-associated colorectal cancer.This narrative review seeks to outline data on dysplasia detection as well as barriers to the implementation of dye-based chromoendoscopy for the prevention and early detection of colitis-associated colorectal cancer.展开更多
基金Supported by in part by the Houston VA HSR&D Center of Excellence,No.HFP90-020
文摘Studies across medical disciplines have shown gaps in the care recommended in evidence based guidelines and the care actually delivered. Quality improvement projects using systematic audit and feedback interventions such as quality measures, will become increasingly important tools to address these gaps in care. These gaps are also apparent in the care of patients with inflammatory bowel disease. Multiple organizations, including the American Gastroenterology Association and the Crohn’s and Colitis Foundation of America, have developed programs designed to implement quality measures to improve the care of inflammatory bowel disease (IBD) patients. Early results show promise of improving quality, but numerous barriers remain. Gastroenterologists need to be aware of these processes to provide the highest care possible to patients with IBD. We review the existing literature on approaches to quality improvement and their potential application and barriers when applied to IBD care.
文摘Traditionally,patients with inflammatory bowel disease(IBD) have been thought to be at increased risk of developing colitis-associated colorectal cancer.Although there are recent data suggesting that rates of colitisassociated cancer in IBD patients is declining,current guidelines still recommend regular dysplasia surveillance for early detection and prevention of neoplasia in patients with IBD.White-light endoscopy with random biopsies has been the traditional approach for dysplasia detection;however,newer technologies and approaches have emerged.One method,dye-based chromoendoscopy,has the potential to detect more dysplasia.However,longitudinal data to showing a benefit in morbidity or mortality from the use of chromoendoscopy are still lacking.Many societies have included recommendation on the use of chromoendoscopy with targeted biopsies as a method of surveillance for colitis-associated colorectal cancer.This narrative review seeks to outline data on dysplasia detection as well as barriers to the implementation of dye-based chromoendoscopy for the prevention and early detection of colitis-associated colorectal cancer.
