Improvise, Adapt, Overcome: How COVID-19 Transformed Inpatient Pediatric Gastroenterology.

The coronavirus disease-2019 (COVID-19) pandemic has disrupted inpatient pediatric services across the United States, creating opportunities for innovation. A recent Webinar organized by the Telehealth for Pediatric GI Care Now working group and sponsored by the North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition provided insights into how inpatient pediatric gastroenterology services were affected and how physicians adapted during the crisis. These findings suggest the use of telehealth technologies may augment family communication and facilitate multidisciplinary care in the future. We anticipate that these innovative applications of telehealth will comprise a part of a toolkit for gastroenterologists to be used during this public health emergency and beyond

Physician Perspectives about Telemedicine: Considering the Usability of Telemedicine in Response to COVID-19

OBJECTIVE: Use of telemedicine in pediatric gastroenterology has increased dramatically in response to the COVID-19 pandemic. The goal of this study was to systematically assess the usability of telemedicine in the field of pediatric gastroenterology. METHODS: The previously validated Telehealth Usability Questionnaire (TUQ) was distributed to physician pediatric gastroenterologist members of NASPGHAN. Physician demographic and practice characteristics were collected. Data were analyzed using descriptive, linear mixed effect and ordinary least squares regression methods. RESULTS: One hundred sixty pediatric gastroenterologists completed the survey. The majority were from academic practice (77%) with experience ranging from trainee (11%) to over 20 years clinical practice (34%). Most (82%) had no experience with telemedicine prior to the pandemic. The average usability score (scale 1-5) was 3.87 (sigma = 0.67) with the highest domain in usefulness of telemedicine (mu = 4.29, sigma = 0.69) and physician satisfaction (mu = 4.13, sigma = 0.79) and the lowest domain in reliability (mu = 3.02, sigma = 0.87). When comparing trainees to attending physicians, trainees\u27 responses were almost 1 point lower on satisfaction with telemedicine (Trainee effect = -.97, Bonferroni adjusted 95% CI = -1.71 to -.23). CONCLUSION: Pediatric gastroenterologists who responded to the survey reported that the technology for telemedicine was usable, but trainees indicated lower levels of satisfaction when compared to attending physicians. Future study is needed to better understand user needs and the impacts of telemedicine on providers with different levels are experience to inform efforts to promote implementation and use of telemedicine beyond the pandemic

International consensus recommendations for eosinophilic gastrointestinal disease nomenclature.

BACKGROUND & AIMS Substantial heterogeneity in terminology used for eosinophilic gastrointestinal diseases (EGID), particularly the catchall term "eosinophilic gastroenteritis", limits clinical and research advances. We aimed to achieve an international consensus for standardized EGID nomenclature. METHODS This consensus process utilized Delphi methodology. An initial naming framework was proposed and refined in iterative fashion, then assessed in a first round of Delphi voting. Results were discussed in two consensus meetings, the framework was updated, and re-assessed in a second Delphi vote, with a 70% threshold set for agreement. RESULTS Of 91 experts participating, 85 (93%) completed the first and 82 (90%) completed the second Delphi surveys. Consensus was reached on all but two statements. "EGID" was the preferred umbrella term for disorders of GI tract eosinophilic inflammation in the absence of secondary causes (100% agreement). Involved GI tract segments will be named specifically and use an "Eo" abbreviation convention: eosinophilic gastritis (now abbreviated EoG), eosinophilic enteritis (EoN), and eosinophilic colitis (EoC). The term "eosinophilic gastroenteritis" is no longer preferred as the overall name (96% agreement). When >2 GI tract areas are involved, the name should reflect all of the involved areas. CONCLUSIONS This international process resulted in consensus for updated EGID nomenclature for both clinical and research use. EGID will be the umbrella term rather than "eosinophilic gastroenteritis", and specific naming conventions by location of GI tract involvement are recommended. As more data are developed, this framework can be updated to reflect best practices and the underlying science