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Background The aim of the study was to evaluate the current opinion and clinical decision-making process of international pancreatologists, and to systematically identify key study questions regarding the diagnosis and treatment of chronic pancreatitis (CP) for future research. Methods An online survey, including questions regarding the diagnosis and treatment of CP and several controversial clinical case vignettes, was send by e-mail to members of various international pancreatic associations: IHPBA, APA, EPC, ESGE and DPSG. Results A total of 288 pancreatologists, 56% surgeons and 44% gastroenterologists, from at least 47 countries, participated in the survey. About half (48%) of the specialists used a classification tool for the diagnosis of CP, including the Mayo Clinic (28%), Mannheim (25%), or Büchler (25%) tools. Overall, CT was the preferred imaging modality for evaluation of an enlarged pancreatic head (59%), pseudocyst (55%), calcifications (75%), and peripancreatic fat infiltration (68%). MRI was preferred for assessment of main pancreatic duct (MPD) abnormalities (60%). Total pancreatectomy with auto-islet transplantation was the preferred treatment in patients with parenchymal calcifications without MPD abnormalities and in patients with refractory pain despite maximal medical, endoscopic, and surgical treatment. In patients with an enlarged pancreatic head, 58% preferred initial surgery (PPPD) versus 42% initial endoscopy. In patients with a dilated MPD and intraductal stones 56% preferred initial endoscopic ± ESWL treatment and 29% preferred initial surgical treatment. Conclusion Worldwide, clinical decision-making in CP is largely based on local expertise, beliefs and disbeliefs. Further development of evidence-based guidelines based on well designed (randomized) studies is strongly encouraged.
Diagnosis and treatment in chronic pancreatitis: an international survey and case vignette study
Issa Y.;van Santvoort H. C.;Fockens P.;Besselink M. G.;Bollen T. L.;Bruno M. J.;Boermeester M. A.;Moody F. G.;Bertrand C.;Johnson C.;van Lander A.;Carter R.;Conneely J. B.;Berrevoet F.;Sousa Silva D.;Li Z. -F.;Levy P.;Oppong K.;Gardner T. B.;Wilcox C. M.;French J.;Steer M.;Bradley E. L.;Layer P.;Napoleon B.;Mosquera J. A.;Gouma D. J.;Andersson R.;Manzelli A.;Klaase J. M.;Falconi M.;de-Madaria E.;Casadei R.;Malleo G.;Pezzilli R.;Malecka-Panas E.;Lohr M.;Mayerle J.;Rauws E. A. J.;Freeman M. L.;Ariffin A. C.;Vasavada B.;Lai P. B. -S.;Beristain-Hernandez J. L.;Juan A.;Plaudis H.;Vrochides D.;Neri V.;Velayutham V.;Andrianov A.;Figueras J.;Soreide K.;Shcherba A.;Gachabayov M.;Keith R. G.;Tsoulfas G.;Fink M. A.;Crippa S.;Nikfarjam M.;Bora D.;Desai R.;Donati M.;Bong J. J.;Martinez Moneo E.;Morris-Stiff G.;Coker A.;de Resende A. P.;Bhalerao S. S.;Sikora S. S.;Kelemen D.;Czako L.;Ramesh H.;Rummo O.;Fedaruk A.;Shcherba A.;Hlinnik A.;Chinthakindi M.;Dumitrascu T.;Egorov V.;Bettschart V.;Molinari M.;Guillermo E. A. D.;Orloff S. L.;Kostov D. V.;Sulpice L.;Knowles B.;Kimura Y.;Marangoni G.;Joshi R.;Gyokeres T.;Bedin;Vladimir V.;Ivanecz A.;Antonucci A.;Omoshoro-Jones J. A. O.;Nakache R.;Del Chiaro M.;Johnstone M.;Saito T.;Balzano G.;Egorov V.;Chooklin S.;Boraschi P.;Park W.;Pereira P. N. V. R.;Pagano N.;Lykoudis P.;Partecke L. I.;Siatkouski A.;Martin R. J.;Kawabata Y.;Lourenco L. C.;Marra-Lopez C.;Lee J. K.;Habbe N.;Verdonk R. C.;Rabotyagova Y.;Talukdar R.;Frulloni L.;Galeev S.;Berger Z.;Yasuda T.;Hackert T.;Saatov Z.;Raptis D. A.;Boadas J.;Vitali F.;Archibugi L.;Ryska M.;Tihanyi B.;Singh V. K.;Masamune A.;Yeaton P.;Smith K. D.;Modi S.;Cosen-Binker L.;Barreto S. G.;Morandi E.;Valeri S.;Morioka C. Y.;Lara L. F.;Takeyama Y.;Gress F. G.;Yu Y. -D.;Gaia E.;Barbu S. T.;Ince A. T.;Deeprasertvit A.;Chang Y. -T.;Abiola S. O.;Kacar S.;Muscarella P.;Braat H.;Han S.;Aghdassi A. A.;Frossard J. -L.;Smith J. P.;Schwartz M. P.;van Dullemen H. M.;Venneman N. G.;Spanier B. W. M.;Kuiken S.;van Geenen E.;Beilman G.;Papachristou G.;Chapa Azuela O.;van der Schaar P.;Oruc N.;Anten M. -P.;Nealon W. H.;Garcia-Cano J.;Jovani M.;Melki Z.;Ibrahim M. M. A.;Awajdarip M. U.;Azam M.;Sabu K. G.;Ermolaev I.;Shetty S.;Oana B.;Pokrotnieks J.;Lazuchiewicz-Kot M.;Bouali R.;Winiarski M.;Schmitt M.;Rimbas M.;Meining A.;Erwan B.;Meier P. N.;Schoefl R.;Altonbary A. Y.;Marsteller I.;Wallstabe I.;Prifti S.;Lemmers A.;Horvath M.;Kumar A.;Palermo J. J.
2017-01-01
Abstract
Background The aim of the study was to evaluate the current opinion and clinical decision-making process of international pancreatologists, and to systematically identify key study questions regarding the diagnosis and treatment of chronic pancreatitis (CP) for future research. Methods An online survey, including questions regarding the diagnosis and treatment of CP and several controversial clinical case vignettes, was send by e-mail to members of various international pancreatic associations: IHPBA, APA, EPC, ESGE and DPSG. Results A total of 288 pancreatologists, 56% surgeons and 44% gastroenterologists, from at least 47 countries, participated in the survey. About half (48%) of the specialists used a classification tool for the diagnosis of CP, including the Mayo Clinic (28%), Mannheim (25%), or Büchler (25%) tools. Overall, CT was the preferred imaging modality for evaluation of an enlarged pancreatic head (59%), pseudocyst (55%), calcifications (75%), and peripancreatic fat infiltration (68%). MRI was preferred for assessment of main pancreatic duct (MPD) abnormalities (60%). Total pancreatectomy with auto-islet transplantation was the preferred treatment in patients with parenchymal calcifications without MPD abnormalities and in patients with refractory pain despite maximal medical, endoscopic, and surgical treatment. In patients with an enlarged pancreatic head, 58% preferred initial surgery (PPPD) versus 42% initial endoscopy. In patients with a dilated MPD and intraductal stones 56% preferred initial endoscopic ± ESWL treatment and 29% preferred initial surgical treatment. Conclusion Worldwide, clinical decision-making in CP is largely based on local expertise, beliefs and disbeliefs. Further development of evidence-based guidelines based on well designed (randomized) studies is strongly encouraged.
Clinical Decision-Making Decision Support Techniques Digestive System Surgical Procedures Endoscopy, Digestive System Gastroenterologists Health Care Surveys Humans Islets of Langerhans Transplantation Lithotripsy Magnetic Resonance Imaging Pancreatectomy Pancreatitis, Chronic Practice Patterns, Physicians' Predictive Value of Tests Risk Factors Tomography, X-Ray Computed Transplantation, Autologous Treatment Outcome
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.11768/109909
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simulazione ASN
Il report seguente simula gli indicatori relativi alla propria produzione scientifica in relazione alle soglie ASN 2023-2025 del proprio SC/SSD. Si ricorda che il superamento dei valori soglia (almeno 2 su 3) è requisito necessario ma non sufficiente al conseguimento dell'abilitazione. La simulazione si basa sui dati IRIS e sugli indicatori bibliometrici alla data indicata e non tiene conto di eventuali periodi di congedo obbligatorio, che in sede di domanda ASN danno diritto a incrementi percentuali dei valori. La simulazione può differire dall'esito di un’eventuale domanda ASN sia per errori di catalogazione e/o dati mancanti in IRIS, sia per la variabilità dei dati bibliometrici nel tempo. Si consideri che Anvur calcola i valori degli indicatori all'ultima data utile per la presentazione delle domande.
La presente simulazione è stata realizzata sulla base delle specifiche raccolte sul tavolo ER del Focus Group IRIS coordinato dall’Università di Modena e Reggio Emilia e delle regole riportate nel DM 589/2018 e allegata Tabella A. Cineca, l’Università di Modena e Reggio Emilia e il Focus Group IRIS non si assumono alcuna responsabilità in merito all’uso che il diretto interessato o terzi faranno della simulazione. Si specifica inoltre che la simulazione contiene calcoli effettuati con dati e algoritmi di pubblico dominio e deve quindi essere considerata come un mero ausilio al calcolo svolgibile manualmente o con strumenti equivalenti.
