Endoscopists attitudes on the publication of "quality" data for endoscopic procedures: a cross-sectional survey

<p>Abstract</p> <p>Background</p> <p>Whilst the public now have access to mortality & morbidity data for cardiothoracic surgeons, such "quality" data for endoscopy are not generally available. We studied endoscopists' attitudes to and the practicality of this data being published.</p> <p>Methods</p> <p>We sent a questionnaire to all consultant gastrointestinal (GI) surgeons, physicians and medical GI specialist registrars in the Northern region who currently perform GI endoscopic procedures (n = 132). We recorded endoscopist demographics, experience and current data collection practice. We also assessed the acceptability and utility of nine items describing endoscopic "quality" (e.g. mortality, complication & completion rates).</p> <p>Results</p> <p>103 (78%) doctors responded of whom 79 were consultants (77%). 61 (59%) respondents were physicians. 77 (75%) collect any "quality" data. The most frequently collected item was colonoscopic completion rate. Data were most commonly collected for appraisal, audit or clinical governance. The majority of doctors (54%) kept these data only available to themselves, and just one allowed the public to access this. The most acceptable data item was annual number of endoscopies and the least was crude upper GI bleeding mortality. Surgeons rated information less acceptable and less useful than physicians. Acceptability and utility scores were not related to gender, length of experience or current activity levels. Only two respondents thought all items totally unacceptable and useless.</p> <p>Conclusion</p> <p>The majority of endoscopists currently collect "quality" data for their practice although these are not widely available. The endoscopists in this study consider the publication of their outcome data to be "fairly unacceptable/not very useful" to "neutral" (score 2–3). If these data were made available to patients, consideration must be given to both its value and its acceptability.</p

Study protocol: UK 2022 Comparative Audit of Acute Upper Gastrointestinal Bleeding (AUGIB) and the use of Blood

Introduction: The last UK-wide audit of the management of acute upper gastrointestinal bleeding (AUGIB) was conducted in 2007. Re-evaluation of current practice is needed, because since then, there have been several initiatives to improve the management of AUGIB including new guidelines, innovative endoscopic therapy, service delivery improvements and expansion of endoscopy provision. Methods and analysis: Consecutive, unselected presentations with AUGIB across all UK NHS hospitals were prospectively enrolled over a 2-month period between May and July 2022. Data will be collected on patient characteristics, comorbidities, use of anticoagulant drugs, transfusion, timing and type of diagnostic and therapeutic procedure, length of stay and mortality. Clinical practice will be audited against predefined minimum standards of care for AUGIB and compared to the results of the 2007 UK-wide audit. Data will be collected on the availability and organisation of care as well as the provision of training for specialist registrars in endoscopic management of AUGIB. Ethics and dissemination: This audit will be conducted as part of the National Comparative Audit of Blood Transfusion through collaboration with specialists in gastroenterology, haematology, surgery, and interventional radiology. Individual site reports will be provided alongside a UK-wide report disseminated through specialist societies and publications in peer-reviewed journals. The study has been funded by National Health Services Blood and Transplant and the British Society of Gastroenterology and endorsed by the Royal Colleges of Physicians, the British Association for the Study of the Liver, the Association of Upper GI Surgeons, and the British Society of Interventional Radiology

The Changes in The Compressive and Tensile Yield Strengths During Uniaxial Cyclic Loading

80 p.Thesis (Ph.D.)--University of Illinois at Urbana-Champaign, 1983.Many of the multiaxial unified-creep plasticity theories which have been proposed as a means to improve design at elevated temperatures have suffered from the drawback that the manner in which the state variables change is difficult to measure. A unified creep-plasticity theory for uniaxial loading which uses the yield strengths in tension, Y(,1), and compression, Y(,2), as the state variables is investigated as the means of improving the formulation of such theories. The yield strengths are easily measured and can be readily transformed to the state variables commonly used in the multiaxial theories.The yield strengths were measured during a completely reversed cyclic strain amplitude history for 304 stainless steel at 23(DEGREES)C and 600(DEGREES)C, and for Inconel 751 at 788(DEGREES)C and 927(DEGREES)C. The data from these experiments were then plotted in the (Y(,1),Y(,2)) plane and a geometric model of how the state variables change during loading was constructed.The model clearly demonstrates that on each loading reversal kinematic hardening is the predominate type of hardening. The observed limit cycle behavior of the state variables requires that there be an isotropic softening, or decrease in the elastic range, at the beginning of each reversal. This is followed by a rapid isotropic hardening at the end of the reversal. However, this behavior was obscured by the scatter in the data which was on the order of 10 percent of the elastic range.U of I OnlyRestricted to the U of I community idenfinitely during batch ingest of legacy ETD