Evidence-Based GI
Which Endoscopists Benefit from Using Computer-Aided Detection of Polyps During Colonoscopy? Philip Schoenfeld, MD, MSEd, MSc (Epi) Chief (Emeritus),…
Post-Colonoscopy Colorectal Cancer Due to Missed Polyps in Proximal Colon or Rectum with Sub-Optimal Bowel Cleansing Jeffrey Lee, MD, MPH…
Dr Philip Okafor looks at a NEJM article on use of thalidomide for GI bleeding due to small intestinal angiodysplasia.
Editor-in-Chief Dr Philip Schoenfeld looks at a Phase 3 trial published in Lancet of 463 patients with IBS treated with tri-cyclic antidepressant and the effect on a patient’s IBS-Symptom Severity Score.
Drs Ashwini Arvind and Nicole E. Rich look at the decade-long, NIH-funded HEDS study for incidence and risk factors for hepatocellular carcinoma in cirrhosis.
In case you missed it! Dr Patel reviews a 2020 RCT published in Lancet that showed use of aspirin in patients with Lynch Syndrome reduced the long-term risk of developing CRC.
Multiple treatments for ulcerative colitis are now available. We look at a study published detailing a multi-center, double-blind, placebo-controlled RCT on etrasimod.
The goal of surveillance is to identify low-grade or high-grade dysplasia or early cancer at a treatable stage, however, current early cancer detection practices are ineffective. One potential explanation for these limitations is PEEC/PEEN, similar to the concept of post-colonoscopy colorectal cancer and related to endoscopy quality.
BD-IPMNs represent one of the more common types of pancreatic cystic lesions, and their surveillance entails cross-sectional imaging and/or endoscopic ultrasound. Surveillance can be offered until a patient is no longer a surgical candidate, though apart from suggestions of considering lengthening intervals if lesions are stable, there is little guidance regarding when to stop surveillance. Given the healthcare burden and cost associated with surveillance, as well as the impact on patients, studies evaluating whether and in whom surveillance can be stopped are critical.
We selected this study, which was published as a Research Letter in JAMA Medicine, because it was publicized extensively in the media. As discussed in prior summaries, the methodology of these epidemiologic reports is frequently flawed and does not confirm or even support a causal relationship between medicine and adverse event.