TY - JOUR
T1 - Overview of the Pediatric Endoscopy Quality Improvement Network Quality Standards and Indicators for Pediatric Endoscopy
T2 - A Joint NASPGHAN/ESPGHAN Guideline
AU - Walsh, Catharine M.
AU - Lightdale, Jenifer R.
AU - Mack, David R.
AU - Amil-Dias, Jorge
AU - Bontems, Patrick
AU - Brill, Herbert
AU - Croft, Nicholas M.
AU - Fishman, Douglas S.
AU - Furlano, Raoul I.
AU - Gillett, Peter M.
AU - Hojsak, Iva
AU - Homan, Matjaž
AU - Huynh, Hien Q.
AU - Jacobson, Kevan
AU - Leibowitz, Ian H.
AU - Lerner, Diana G.
AU - Liu, Quin Y.
AU - Mamula, Petar
AU - Narula, Priya
AU - Oliva, Salvatore
AU - Riley, Matthew R.
AU - Rosh, Joel R.
AU - Tavares, Marta
AU - Utterson, Elizabeth C.
AU - Ambartsumyan, Lusine
AU - Otley, Anthony R.
AU - Kramer, Robert E.
AU - Connan, Veronik
AU - McCreath, Graham A.
AU - Thomson, Mike A.
N1 - Funding Information:
Funding for the consensus meeting was provided by NASPGHAN and ESPGHAN, and NASPGHAN administered all aspects of the in-person meeting. The protocol was approved by both NASPGHAN and ESPGHAN, who agreed to develop a joint societal guideline. The views of the funding bodies did not influence the content of the guideline. In accordance with NASPGHAN and ESPGHAN policy, written disclosures of any potential conflicts of interest for the preceding 24 months were recorded by all PEnQuIN working group members and reviewed in accordance with societal policies. No concerns were identified.
Funding Information:
Conflicts of interest: P.B. has served on the advisory boards of Biocodex, Nutricia, and Avanos. P.B. has received honoraria for speaking engagements from AbbVie, Nutricia, and Avanos. N.M.C.'s institution received speaker fees, advisory board fees, and research funding on his behalf from AbbVie, Eli Lilly, Takeda, Shire, Pfizer, and 4D Pharma. D.S.F. has received royalties from UpToDate (“Pediatric Caustic Ingestions”). I.H. has received honoraria for speaking engagements from BioGaia, Oktal Pharma, Nutricia, Abela Pharm, and Nestle. H.Q.H. has received research support from Janssen, AbbVie, Takeda, and Allergan. H.Q.H. has served on the advisory boards of AbbVie and Jansen. K.J. has received research support from Janssen, AbbVie, and the Center for Drug Research and Development (CDRD). K.J. has served on the advisory boards of Janssen, AbbVie, and Merck and participates in the speaker's bureau for AbbVie and Janssen. D.G.L. has received consultant fees from EvoEndo. J.R.L. has received research support from AbbVie and an honorarium from Mead Johnson. A.R.O. has received research support from Janssen, AbbVie, Pfizer and Eli Lilly. A.R.O. has served on the advisory boards of Janssen, AbbVie, and Eli Lilly and participates in the speaker's bureau for AbbVie and Janssen. J.R.R. has received research support from AbbVie and Janssen. J.R.R. has served on the advisory boards of Janssen, BMS, Eli Lilly, and Pfizer. C.M.W. has received research support from AbbVie.
Funding Information:
Funding/support: C.M.W. holds a Career Development Award from the Canadian Child Health Clinician Scientist Program and an Early Researcher Award from the Ontario Ministry of Research and Innovation. D.R.M. is funded in part by a University of Ottawa, Faculty of Medicine Distinguished Clinical Research Chair award. The funders had no role in the design and conduct of the study, decision to publish and preparation, review or approval of the manuscript.
Publisher Copyright:
© 2022 Lippincott Williams and Wilkins. All rights reserved.
PY - 2022/3/1
Y1 - 2022/3/1
N2 - Introduction:Pediatric-specific quality standards for endoscopy are needed to define best practices, while measurement of associated indicators is critical to guide quality improvement. The international Pediatric Endoscopy Quality Improvement Network (PEnQuIN) working group was assembled to develop and define quality standards and indicators for pediatric gastrointestinal endoscopic procedures through a rigorous guideline consensus process.Methods:The Appraisal of Guidelines for REsearch and Evaluation (AGREE) II instrument guided PEnQuIN members, recruited from 31 centers of various practice types representing 11 countries, in generating and refining proposed quality standards and indicators. Consensus was sought via an iterative online Delphi process, and finalized at an in-person conference. Quality of evidence and strength of recommendations were rated according to the GRADE (Grading of Recommendation Assessment, Development, and Evaluation) approach.Results:Forty-nine quality standards and 47 indicators reached consensus, encompassing pediatric endoscopy facilities, procedures, endoscopists, and the patient experience. The evidence base for PEnQuIN standards and indicators was largely adult-based and observational, and downgraded for indirectness, imprecision, and study limitations to "very low" quality, resulting in "conditional" recommendations for most standards (45/49).Conclusions:The PEnQuIN guideline development process establishes international agreement on clinically meaningful metrics that can be used to promote safety and quality in endoscopic care for children. Through PEnQuIN, pediatric endoscopists and endoscopy services now have a framework for auditing, providing feedback, and ultimately, benchmarking performance. Expansion of evidence and prospective validation of PEnQuIN standards and indicators as predictors of clinically relevant outcomes and high-quality pediatric endoscopic care is now a research priority.
AB - Introduction:Pediatric-specific quality standards for endoscopy are needed to define best practices, while measurement of associated indicators is critical to guide quality improvement. The international Pediatric Endoscopy Quality Improvement Network (PEnQuIN) working group was assembled to develop and define quality standards and indicators for pediatric gastrointestinal endoscopic procedures through a rigorous guideline consensus process.Methods:The Appraisal of Guidelines for REsearch and Evaluation (AGREE) II instrument guided PEnQuIN members, recruited from 31 centers of various practice types representing 11 countries, in generating and refining proposed quality standards and indicators. Consensus was sought via an iterative online Delphi process, and finalized at an in-person conference. Quality of evidence and strength of recommendations were rated according to the GRADE (Grading of Recommendation Assessment, Development, and Evaluation) approach.Results:Forty-nine quality standards and 47 indicators reached consensus, encompassing pediatric endoscopy facilities, procedures, endoscopists, and the patient experience. The evidence base for PEnQuIN standards and indicators was largely adult-based and observational, and downgraded for indirectness, imprecision, and study limitations to "very low" quality, resulting in "conditional" recommendations for most standards (45/49).Conclusions:The PEnQuIN guideline development process establishes international agreement on clinically meaningful metrics that can be used to promote safety and quality in endoscopic care for children. Through PEnQuIN, pediatric endoscopists and endoscopy services now have a framework for auditing, providing feedback, and ultimately, benchmarking performance. Expansion of evidence and prospective validation of PEnQuIN standards and indicators as predictors of clinically relevant outcomes and high-quality pediatric endoscopic care is now a research priority.
KW - Endoscopy
KW - Gastrointestinal/∗standards
KW - Key performance indicators
KW - Pediatric gastroenterology/∗standards
KW - Practice guidelines as topic/∗standards
KW - Quality assurance
UR - http://www.scopus.com/inward/record.url?scp=85125552882&partnerID=8YFLogxK
U2 - 10.1097/MPG.0000000000003262
DO - 10.1097/MPG.0000000000003262
M3 - Review article
C2 - 34402484
AN - SCOPUS:85125552882
SN - 0277-2116
VL - 74
SP - S3-S15
JO - Journal of Pediatric Gastroenterology and Nutrition
JF - Journal of Pediatric Gastroenterology and Nutrition
ER -