A5040552212- Colorectal Cancer Screening and Detection
- Global Healthcare and Medical Tourism
- Gastric Cancer Management and Outcomes
- Social Media in Health Education
- Prostate Cancer Treatment and Research
- NF-κB Signaling Pathways
- Healthcare professionals’ stress and burnout
- Diverticular Disease and Complications
- Pancreatic and Hepatic Oncology Research
- Global Cancer Incidence and Screening
- Venous Thromboembolism Diagnosis and Management
- COVID-19 and healthcare impacts
- Genetic factors in colorectal cancer
- Dietetics, Nutrition, and Education
- Renal Diseases and Glomerulopathies
- Colorectal and Anal Carcinomas
- Patient-Provider Communication in Healthcare
- Nutritional Studies and Diet
- Perfectionism, Procrastination, Anxiety Studies
- Radiology practices and education
- Healthcare cost, quality, practices
- Interprofessional Education and Collaboration
- Radiation Dose and Imaging
- Aortic Disease and Treatment Approaches
- Complement system in diseases
Newcastle University
2020-2024
Newcastle upon Tyne Hospitals NHS Foundation Trust
2023-2024
National Health Service
2024
Royal Victoria Infirmary
2024
University Hospital of North Tees
2020-2023
North Tees and Hartlepool NHS Foundation Trust
2016-2022
University of Sunderland
2021
University of Twente
2021
University of Newcastle Australia
2020
Cumberland Infirmary
2016
Thrombotic microangiopathies are rare conditions characterized by microangiopathic hemolytic anemia, microthrombi, and multiorgan insult. The disorders, which include uremic syndrome thrombotic thrombocytopenic purpura, often acute life threatening. We report a retrospective analysis of 65 patients presenting to our institution from 1997 2008 with all forms microangiopathy. Therapeutic plasma exchange was requirement for were referred institution; 66% female median age at presentation 52...
Big data is defined as being large, varied or frequently updated, and usually generated from real-world interaction. With the unprecedented availability of big data, comes an obligation to maximise its potential for healthcare improvements in treatment effectiveness, disease prevention delivery. We review opportunities challenges that brings gastroenterology. sources improvement gastroenterology, including electronic medical records, patient registries patient-generated data. can complement...
Background Audit and feedback (A&F) interventions improve patient care but may result in unintended consequences. To evaluate plausible harms maximise benefits, theorisation using logic models can be useful. We aimed to explore the adverse effects of colonoscopy A&F a intervention theory (FIT) dark model before National Endoscopy Database Automated Performance Reports Improve Quality Outcomes Trial study. Methods undertook qualitative study exploring practices colonoscopy. Interviews...
Introduction The COVID-19 pandemic has profoundly affected UK endoscopy workload. Joint Advisory Group on GI and British Society of Gastroenterology issued guidelines service delivery changes restoration. We surveyed clinical leads to gain insights into Methods A Google Forms-designed survey, assessing provision, Covid minimisation referral pathways was circulated all leads. survey open between 19 24 May 2020. Results 97 completed the with nations regions represented. Analysis showed 20%...
BACKGROUND & AIMS:Postcolonoscopy Q10 colorectal cancer incidence and mortality rates are higher for endoscopists with low polyp detection rates.Using the UK's National Endoscopy Database (NED), which automatically captures real-time data, we assessed if providing feedback of case-mix-adjusted mean number polyps (aMNP), as a key performance indicator, improved endoscopists' performance.Feedback was delivered via theory-informed, evidence-based audit intervention. METHODS:This multicenter,...
Prostate cancer (Pca) is the most common form of affecting men, despite recent advances in PCa treatments, one third patients diagnosed each year succumb to this disease. The inflammatory response has been implicated prostate prog
Objective To estimate and quantify the cost implications health impacts of improving performance English endoscopy services to optimum quality as defined by postcolonoscopy colorectal cancer (PCCRC) rates. Design A semi-Markov state-transition model was constructed, following logical treatment pathway individuals who could potentially undergo a diagnostic colonoscopy. The consisted three identical arms, each representing high, middle or low-performing trust’s service, PCCRC cohort...
Abstract Background and study aims Colonoscopists with low polyp detection have higher post colonoscopy colorectal cancer incidence mortality rates. The United Kingdom’s National Endoscopy Database (NED) automatically captures patient level data in real time provides endoscopy key performance indicators (KPI) at a national, center, individual level. Using an electronic behavior change intervention, the primary objective of this is to assess if automated feedback endoscopist center-level...
Abstract Background To address mismatch between routine endoscopy capacity and demand, centers often implement initiatives to increase capacity, such as weekend working or using locums/agency staff (insourcing). However, there are concerns that may negatively impact quality. We investigated polyp detection for vs. weekday insourced standard procedures data from the UK National Endoscopy Database. Methods conducted a national, retrospective, cross-sectional study of diagnostic colonoscopies...
Abstract Aim A diagnosis of colorectal polyp cancer presents a treatment dilemma. The decision between segmental resection versus endoscopic surveillance is difficult due to lack good quality clinical evidence for either option. aim this study was understand the making experiences both clinicians and patients when faced with such diagnosis. Methods Qualitative, semi‐structured interviews were undertaken 10 involved in care diagnosed five who had experience cancer. All from four hospital...
To evaluate whether the simulation environment is a significant contributor to stress for participants of high-fidelity teaching, and heart rate realistic practical surrogate measure within simulation. Seven third-year medical students underwent continuous ambulatory monitoring while performing an upper gastrointestinal haemorrhage. Pre- post-simulation Likert-style questionnaires were distributed, in which rated their levels perceived anxiety regarding selection common clinical situations …
We describe the case of an 83-year-old lady with a known aneurysmal thoracic aorta, developing acute breathlessness and hypoxia, no pain unremarkable cardiovascular examination. As d-dimers were raised, she was treated low-molecular-weight heparin (LMWH) for suspected pulmonary embolism. CT angiography showed acutely dissecting, Type-A, aortic aneurysm. The patient medically β-blockers. Despite poor prognosis, remains well 2 months later. Observational studies patients over 70 Type-A...
<h3>Introduction</h3> Post-colonoscopy colorectal cancer incidence and mortality rates are higher for endoscopists with low polyp detection rates. Using the UK's National Endoscopy Database (NED), which automatically captures data real-time, we assessed if providing feedback of case-mix-adjusted Mean Number Polyps (aMNP), a key performance indicator (KPI), in theory-informed evidence-based behaviour change intervention improved endoscopists' performance. <h3>Methods</h3> The multicentre,...
<h3>Introduction</h3> The NHS has committed to achieve 'net zero' carbon emissions by 2040. Nationally endoscopy is the third highest emitting hospital department; driven in part high single-use instrument turnover currently incinerated S32 sharps bins. Sharpsmart MR64 Clinismart bins (figure 1) have lower than traditional as they are sterilised, recycled and reused. Our green working-group (GEW) aimed reduce endoscopy's through piloting MR64-bins' assessing their impact on staff practices...
Aims APRIQOT uses NED to provide endoscopists feedback on colonic detection KPI. Traditional adenoma rate is dependent unavailable histological data. Our aim was gain expert consensus which available KPI are acceptable endoscopists.
<h3>Introduction</h3> Automated Performance Reports to Improve Quality Outcomes Trial (APRIQOT) uses NED provide endoscopists feedback on colonic detection KPI. Traditional adenoma rate is dependent unavailable histological data. Our aim was gain expert consensus which available KPI are acceptable endoscopists. <h3>Method</h3> A Delphi panel of UK recruited online, purposively for professional background. Panellists interacted using an online form. In round one we provided a summary and...
Abstract Background Audit and feedback (A&F) interventions improve patient care but may result in negative effects. To evaluate plausible harms maximise benefits, a-priori theorisation using dark logic models can be useful. We aimed to assess the unintended adverse effects of A&F colonoscopy Feedback Intervention Theory (FIT) based model. Methods As part National Endoscopy Database Automated Performance Reports Improve Quality Outcomes Trial we undertook a qualitative study exploring...
<h3>Introduction</h3> Colonoscopists with low polyp detection rates (PDR) have higher post colonoscopy colorectal cancer rates. Audit and feedback (A&F) interventions modestly improve performance in clinical contexts, but most lack theoretical underpinnings so how they work is not understood. We aimed to develop a behaviour change intervention (BCI) giving endoscopists mean number of polyps (MNP) detected. <h3>Methods</h3> An A&F literature review will inform draft BCI: report on...
<h3>Introduction</h3> Due to the mismatch between endoscopy capacity and demand, many centres use in-reach services at weekends. We used data from National Endoscopy Database investigate whether (1) patient characteristics on weekdays weekends differ (2) weekend procedures are associated with lower polyp detection, after accounting for characteristics. <h3>Methods</h3> conducted a retrospective cross-sectional study using independent colonoscopies 01/01-04/04/2019. Procedures had be...
<h3>Introduction</h3> The increased use of DOACs in medicine, is a challenge for endoscopy unit staff, faced with new anticoagulants, national guidance based on low quality evidence, and renal function tests to interpret. Guidance by Veitch (2016) systematic review Woodhouse (2013) suggest practical management algorithms endoscopy, which we aimed summarise into an interactive case teaching session, improve nursing confidence. <h3>Methods</h3> We developed hour long course all nurses our...
Sierra Leone is a resource poor country in Subsaharan Africa. Medical services are rudimentary, with no previous adult endoscopy. Since 2016 our team of UK endoscopists and endoscopy nurses have developed sustainable service model Freetown, providing training to international quality standards.
<h3>Introduction</h3> Standards for management of Barrett's Oesophagus (BO) in the UK are outlined relevant British Society Gastroenterology (BSG) guidelines. Each organisation should have a dedicated Team (BT) to facilitate delivery high quality service, from clinical but also an administrative perspective. Our audit was designed assess performance service our Trust. <h3>Methods</h3> The undertaken two 6-month cycles September 2020 2021. Data collected by reviewing endoscopy reports,...