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Title: DECIDE: Delphi Expert Consensus Statement on Inflammatory Bowel Disease Dysplasia Shared Management Decision-Making.
Austin Authors: Kabir, Misha;Thomas-Gibson, Siwan;Tozer, Phil J;Warusavitarne, Janindra;Faiz, Omar;Hart, Ailsa;Allison, Lisa;Acheson, Austin G;Atici, Semra Demirli;Avery, Pearl;Brar, Mantaj;Carvello, Michele;Choy, Matthew C ;Dart, Robin J;Davies, Justin;Dhar, Anjan;Din, Shahida;Hayee, Bu'Hussain;Kandiah, Kesavan;Katsanos, Konstantinos H;Lamb, Christopher Andrew;Limdi, Jimmy K;Lovegrove, Richard E;Myrelid, Pär;Noor, Nurulamin;Papaconstantinou, Ioannis;Petrova, Dafina;Pavlidis, Polychronis;Pinkney, Thomas;Proud, David ;Radford, Shellie;Rao, Rohit;Sebastian, Shaji;Segal, Jonathan P;Selinger, Christian;Spinelli, Antonino;Thomas, Kathryn;Wolthuis, Albert;Wilson, Ana
Affiliation: University College London Hospitals NHS Foundation Trust, 235 Euston Road, London
Imperial College London
Austin Health
IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan, Italy
Royal Free Hospital, London, UK.
University of Health Sciences Tepecik Training and Research Hospital, Izmir, Turkey.
St Mark's Hospital, London, UK.
Mount Sinai Hospital, University of Toronto.
Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy
Medicine (University of Melbourne)
Guy's and St Thomas' NHS Foundation Trust and King's College London, UK.
Addenbrooke's Hospital, Cambridge.;University of Cambridge.
Darlington Memorial Hospital, County Durham & Darlington NHS Foundation Trust, Teesside University, UK.
Edinburgh IBD Unit, NHS Lothian, Western General Hospital, Crewe Road South, Edinburgh.
King's College Hospital, London, UK.
St. George's University Hospitals NHS Foundation Trust, London, UK.
Division of Gastroenterology, University of Ioannina School of Health Sciences, 45110 Ioannina, Greece.
Translational & Clinical Research Institute, Newcastle University.;Royal Victoria Infirmary, Newcastle upon Tyne.
Northern Care Alliance NHS Foundation Trust, University of Manchester.
Worcestershire Acute Hospitals NHS Trust.
Dept of Surgery, Linköping University Hospital, Sweden
Cambridge University Hospitals, Addenbrooke's Hospital, Hills Road, Cambridge.
Department of Surgery, Aretaieion Hospital, National and Kapodistrian University of Athens. Vas Sofias 76, 11528, Athens, Greece.
Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.;Escuela Andaluza de Salud Pública (EASP), Granada, Spain.;CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
Guy's and St Thomas' NHS Foundation Trust, London, UK.;King's College London, UK.
University Hospitals Birmingham, UK.
Nottingham University Hospitals NHS Trust, UK.
The Royal London Hospital, Barts Health NHS Trust, London, UK.
Hull University Teaching Hospitals NHS Trust, UK.
Department of Gastroenterology, Northern Hospital Epping, Melbourne, VIC, 3076 Australia, University of Melbourne.
Leeds Teaching Hospitals NHS Trust, UK.
Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy.;IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan, Italy.
University Hospital Leuven, Netherlands.
Department of Internal Medicine, Faculty of Medicine, University of Ioannina School of Health Sciences, 45110 Ioannina, Greece.
Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
Issue Date: 8-Nov-2023
Date: 2023
Publication information: Journal of Crohn's & Colitis 2023-11-08; 17(10)
Abstract: Inflammatory Bowel Disease colitis-associated dysplasia is managed with either enhanced surveillance and endoscopic resection or prophylactic surgery. The rate of progression to cancer after a dysplasia diagnosis remains uncertain in many cases and patients have high thresholds for accepting proctocolectomy. Individualised discussion of management options is encouraged to take place between patients and their multidisciplinary teams for best outcomes. We aimed to develop a toolkit to support a structured, multidisciplinary and shared decision-making approach to discussions about dysplasia management options between clinicians and their patients. Evidence from systematic literature reviews, mixed-methods studies conducted with key stakeholders and decision-making expert recommendations were consolidated to draft consensus statements by the DECIDE steering group. These were then subjected to an international, multidisciplinary modified electronic Delphi process until an a priori threshold of 80% agreement was achieved to establish consensus for each statement. 31 members (15 gastroenterologists, 14 colorectal surgeons and two nurse specialists) from 9 countries formed the Delphi panel. We present the 18 consensus statements generated after two iterative rounds of anonymous voting. By consolidating evidence for best practice using literature review, key stakeholder and decision-making expert consultation we have developed international consensus recommendations to support healthcare professionals counselling patients on the management of high cancer risk colitis-associated dysplasia. The final toolkit includes clinician and patient decision aids to facilitate shared decision-making.
DOI: 10.1093/ecco-jcc/jjad083
ORCID: 0000-0003-3991-1015
Journal: Journal of Crohn's & Colitis
PubMed URL: 37171140
ISSN: 1876-4479
Type: Journal Article
Subjects: Inflammatory bowel disease
dysplasia management
Appears in Collections:Journal articles

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