Download PDF
Endoscopy 2014; 46(06): 513-525
DOI: 10.1055/s-0034-1365394
Review
© Georg Thieme Verlag KG Stuttgart · New York

Methodological quality of guidelines in gastroenterology

Rui Malheiro
1   CINTESIS/CIDES – Health Information and Decision Sciences Department, Oporto Faculty of Medicine, Oporto, Portugal
,
Matilde de Monteiro-Soares
1   CINTESIS/CIDES – Health Information and Decision Sciences Department, Oporto Faculty of Medicine, Oporto, Portugal
,
Cesare Hassan
2   Gastroenterology and Digestive Endoscopy, Nuovo Regina Margherita Hospital, Rome, Italy
,
Mário Dinis-Ribeiro
1   CINTESIS/CIDES – Health Information and Decision Sciences Department, Oporto Faculty of Medicine, Oporto, Portugal
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2014 (online)

Also available at
    Permissions and Reprints

Background and study aims: Clinical guidelines are a common feature in modern endoscopy practice and they are being produced faster than ever. However, their methodological quality is rarely assessed. This study evaluated the methodological quality of current clinical guidelines in the field of gastroenterology, with an emphasis on endoscopy.

Materials and methods: Practice guidelines published by the American College of Gastroenterology (ACG), American Gastroenterological Association (AGA), American Society for Gastrointestinal Endoscopy (ASGE), European Society of Gastrointestinal Endoscopy (ESGE), British Society of Gastroenterology (BSG), National Institute for Health and Care Excellence (NICE), and the Scottish Intercollegiate Guidelines Network (SIGN) were searched between September and October 2012 and evaluated using the AGREE II (Appraisal of Guidelines for Research and Evaluation) instrument (23 items, scores 1 – 7 for each item; higher scores mean better quality).

Results: A total of 100 guidelines were assessed. The mean number of items scoring 6 or 7 per guideline was 9.2 (out of 23 items). Overall, 99 % of guidelines failed to include the target population in the development process, and 96 % did not report facilitators and barriers to guideline application. In addition, 86 % did not include advice or tools, and 94 % did not present monitoring or auditing criteria.

Conclusion: The global methodological quality of clinical guidelines in the field of gastroenterology is poor, particularly regarding involvement of the target population in the development of guidelines and in the provision of clear suggestions to practitioners.

 

  • References

  • 1 AGREE Collaboration. Development and validation of an international appraisal instrument for assessing the quality of clinical practice guidelines: the AGREE project. Qual Saf Health Care 2003; 12: 18-23
    CrossrefPubMedGoogle Scholar
  • 2 Grilli R, Magrini N, Penna A et al. Practice guidelines developed by specialty societies: the need for a critical appraisal. Lancet 2000; 355: 103-106
    CrossrefPubMedGoogle Scholar
  • 3 Management of acute upper and lower gastrointestinal bleeding. Edinburgh: Scottish Intercollegiate Guidelines Network; 2008 Available from: http://www.sign.ac.uk/pdf/sign105.pdf. Accessed: 31 October 2012
    PubMedGoogle Scholar
  • 4 Rey JF, Lambert R. ESGE recommendations for quality control in gastrointestinal endoscopy: guidelines for image documentation in upper and lower GI endoscopy. Endoscopy 2001; 33: 901-903
    Article in Thieme ConnectPubMedGoogle Scholar
  • 5 Grol R, Dalhuijsen J, Thomas S et al. Attributes of clinical guidelines that influence use of guidelines in general practice: observational study. BMJ 1998; 317: 858-861
    PubMedGoogle Scholar
  • 6 Cates JR, Young DN, Bowerman DS et al. An independent AGREE evaluation of the Occupational Medicine Practice Guidelines. Spine J 2006; 6: 72-77
    CrossrefPubMedGoogle Scholar
  • 7 Atkins D, Best D, Briss PA et al. Grading quality of evidence and strength of recommendations. BMJ 2004; 328: 1490
    CrossrefPubMedGoogle Scholar
  • 8 Eisen GM, Dominitz JA, Faigel DO. Guidelines for credentialing and granting privileges for endoscopic ultrasound. Gastrointest Endosc 2001; 54: 811-814
    CrossrefPubMedGoogle Scholar
  • 9 Eisen GM, Baron TH, Dominitz JA et al. Acute colonic pseudo-obstruction. Gastrointest Endosc 2002; 56: 789-792
    CrossrefPubMedGoogle Scholar
  • 10 Eisen GM, Baron TH, Dominitz JA et al. Complications of upper GI endoscopy. Gastrointest Endosc 2002; 55: 784-793
    CrossrefPubMedGoogle Scholar
  • 11 Faigel DO, Eisen GM, Baron TH et al. Preparation of patients for GI endoscopy. Gastrointest Endosc 2003; 57: 446-450
    CrossrefPubMedGoogle Scholar
  • 12 Baron TH, Mallery JS, Hirota WK et al. The role of endoscopy in the evaluation and treatment of patients with pancreaticobiliary malignancy. Gastrointest Endosc 2003; 58: 643-649
    CrossrefPubMedGoogle Scholar
  • 13 Jacobson BC, Hirota W, Baron TH et al. The role of endoscopy in the assessment and treatment of esophageal cancer. Gastrointest Endosc 2003; 57: 817-822
    CrossrefPubMedGoogle Scholar
  • 14 Adler DG, Jacobson BC, Davila RE et al. ASGE guideline: complications of EUS. Gastrointest Endosc 2005; 61: 8-12
    CrossrefPubMedGoogle Scholar
  • 15 Zuckerman MJ, Hirota WK, Adler DG et al. ASGE guideline: the management of low-molecular-weight heparin and nonaspirin antiplatelet agents for endoscopic procedures. Gastrointest Endosc 2005; 61: 189-194
    CrossrefPubMedGoogle Scholar
  • 16 Davila RE, Rajan E, Adler D et al. ASGE guideline: the role of endoscopy in the diagnosis, staging, and management of colorectal cancer. Gastrointest Endosc 2005; 61: 1-7
    CrossrefPubMedGoogle Scholar
  • 17 Davila RE, Rajan E, Adler DG et al. ASGE Guideline: the role of endoscopy in the patient with lower-GI bleeding. Gastrointest Endosc 2005; 62: 656-660
    CrossrefPubMedGoogle Scholar
  • 18 Jacobson BC, Baron TH, Adler DG et al. ASGE guideline: The role of endoscopy in the diagnosis and the management of cystic lesions and inflammatory fluid collections of the pancreas. Gastrointest Endosc 2005; 61: 363-370
    CrossrefPubMedGoogle Scholar
  • 19 Qureshi W, Adler DG, Davila R et al. ASGE Guideline: the role of endoscopy in the management of variceal hemorrhage, updated July 2005. Gastrointest Endosc 2005; 62: 651-655
    CrossrefPubMedGoogle Scholar
  • 20 Qureshi W, Adler DG, Davila RE et al. ASGE guideline: guideline on the use of endoscopy in the management of constipation. Gastrointest Endosc 2005; 62: 199-201
    CrossrefPubMedGoogle Scholar
  • 21 Egan JV, Baron TH, Adler DG et al. Esophageal dilation. Gastrointest Endosc 2006; 63: 755-760
    CrossrefPubMedGoogle Scholar
  • 22 Qureshi WA, Zuckerman MJ, Adler DG et al. ASGE guideline: modifications in endoscopic practice for the elderly. Gastrointest Endosc 2006; 63: 566-569
    CrossrefPubMedGoogle Scholar
  • 23 Leighton JA, Shen B, Baron TH et al. ASGE guideline: endoscopy in the diagnosis and treatment of inflammatory bowel disease. Gastrointest Endosc 2006; 63: 558-565
    CrossrefPubMedGoogle Scholar
  • 24 Davila RE, Rajan E, Baron TH et al. ASGE guideline: colorectal cancer screening and surveillance. Gastrointest Endosc 2006; 63: 546-557
    CrossrefPubMedGoogle Scholar
  • 25 Hirota WK, Zuckerman MJ, Adler DG et al. ASGE guideline: the role of endoscopy in the surveillance of premalignant conditions of the upper GI tract. Gastrointest Endosc 2006; 63: 570-580
    CrossrefPubMedGoogle Scholar
  • 26 Adler DG, Qureshi W, Davila R et al. The role of endoscopy in ampullary and duodenal adenomas. Gastrointest Endosc 2006; 64: 849-854
    CrossrefPubMedGoogle Scholar
  • 27 Adler DG, Lichtenstein D, Baron TH et al. The role of endoscopy in patients with chronic pancreatitis. Gastrointest Endosc 2006; 63: 933-937
    CrossrefPubMedGoogle Scholar
  • 28 Gan SI, Rajan E, Adler DG et al. Role of EUS. Gastrointest Endosc 2007; 66: 425-434
    CrossrefPubMedGoogle Scholar
  • 29 Zuckerman MJ, Shen B, Harrison 3rd ME et al. Informed consent for GI endoscopy. Gastrointest Endosc 2007; 66: 213-218
    CrossrefPubMedGoogle Scholar
  • 30 Lichtenstein DR, Cash BD, Davila R et al. Role of endoscopy in the management of GERD. Gastrointest Endosc 2007; 66: 219-224
    CrossrefPubMedGoogle Scholar
  • 31 Ikenberry SO, Harrison ME, Lichtenstein D et al. The role of endoscopy in dyspepsia. Gastrointest Endosc 2007; 66: 1071-1075
    CrossrefPubMedGoogle Scholar
  • 32 Anderson MA, Gan SI, Fanelli RD et al. Role of endoscopy in the bariatric surgery patient. Gastrointest Endosc 2008; 68: 1-10
    CrossrefPubMedGoogle Scholar
  • 33 Banerjee S, Gan SI, Fanelli RD et al. Antibiotic prophylaxis for GI endoscopy. Gastrointest Endosc 2008; 67: 791-798
    CrossrefPubMedGoogle Scholar
  • 34 Banerjee S, Shen B, Nelson DB et al. Infection control during GI endoscopy. Gastrointest Endosc 2008; 67: 781-790
    CrossrefPubMedGoogle Scholar
  • 35 Lee KK, Anderson MA, Baron TH et al. Modifications in endoscopic practice for pediatric patients. Gastrointest Endosc 2008; 67: 1-9
    CrossrefPubMedGoogle Scholar
  • 36 Levy MJ, Anderson MA, Baron TH et al. Position statement on routine laboratory testing before endoscopic procedures. Gastrointest Endosc 2008; 68: 827-832
    CrossrefPubMedGoogle Scholar
  • 37 Lichtenstein DR, Jagannath S, Baron TH et al. Sedation and anesthesia in GI endoscopy. Gastrointest Endosc 2008; 68: 815-826
    CrossrefPubMedGoogle Scholar
  • 38 Anderson MA, Ben-Menachem T, Gan SI et al. Management of antithrombotic agents for endoscopic procedures. Gastrointest Endosc 2009; 70: 1060-1070
    CrossrefPubMedGoogle Scholar
  • 39 Fisher L, Lee KrinskyM, Anderson MA et al. The role of endoscopy in the management of obscure GI bleeding. Gastrointest Endosc 2010; 72: 471-479
    CrossrefPubMedGoogle Scholar
  • 40 Harrison ME, Anderson MA, Appalaneni V et al. The role of endoscopy in the management of patients with known and suspected colonic obstruction and pseudo-obstruction. Gastrointest Endosc 2010; 71: 669-679
    CrossrefPubMedGoogle Scholar
  • 41 Maple JT, Ben-Menachem T, Anderson MA et al. The role of endoscopy in the evaluation of suspected choledocholithiasis. Gastrointest Endosc 2010; 71: 1-9
    CrossrefPubMedGoogle Scholar
  • 42 Shen B, Khan K, Ikenberry SO et al. The role of endoscopy in the management of patients with diarrhea. Gastrointest Endosc 2010; 71: 887-892
    CrossrefPubMedGoogle Scholar
  • 43 Fisher DA, Maple JT, Ben-Menachem T et al. Complications of colonoscopy. Gastrointest Endosc 2011; 74: 745-752
    CrossrefPubMedGoogle Scholar
  • 44 Jain R, Maple JT, Anderson MA et al. The role of endoscopy in enteral feeding. Gastrointest Endosc 2011; 74: 7-12
    CrossrefPubMedGoogle Scholar
  • 45 Petersen BT, Chennat J, Cohen J et al. Multisociety guideline on reprocessing flexible gastrointestinal endoscopes: 2011. Gastrointest Endosc 2011; 73: 1075-1084
    CrossrefPubMedGoogle Scholar
  • 46 Ikenberry SO, Jue TL, Anderson MA et al. Management of ingested foreign bodies and food impactions. Gastrointest Endosc 2011; 73: 1085-1091
    CrossrefPubMedGoogle Scholar
  • 47 Fukami N, Anderson MA, Khan K et al. The role of endoscopy in gastroduodenal obstruction and gastroparesis. Gastrointest Endosc 2011; 74: 13-21
    CrossrefPubMedGoogle Scholar
  • 48 Jue TL, Sharaf RN, Appalaneni V et al. Role of EUS for the evaluation of mediastinal adenopathy. Gastrointest Endosc 2011; 74: 239-245
    CrossrefPubMedGoogle Scholar
  • 49 Ben-Menachem T, Decker GA, Early DS et al. Adverse events of upper GI endoscopy. Gastrointest Endosc 2012; 76: 707-718
    CrossrefPubMedGoogle Scholar
  • 50 Early DS, Ben-Menachem T, Decker GA et al. Appropriate use of GI endoscopy. Gastrointest Endosc 2012; 75: 1127-1131
    CrossrefPubMedGoogle Scholar
  • 51 Shergill AK, Ben-Menachem T, Chandrasekhara V et al. Guidelines for endoscopy in pregnant and lactating women. Gastrointest Endosc 2012; 76: 18-24
    CrossrefPubMedGoogle Scholar
  • 52 Hwang JH, Fisher DA, Ben-Menachem T et al. The role of endoscopy in the management of acute non-variceal upper GI bleeding. Gastrointest Endosc 2012; 75: 1132-1138
    Google Scholar
  • 53 Dieterich DT, Wilcox CM. Diagnosis and treatment of esophageal diseases associated with HIV infection. Practice Parameters Committee of the American College of Gastroenterology. Am J Gastroenterol 1996; 91: 2265-2269
    PubMedGoogle Scholar
  • 54 Fekety R. Guidelines for the diagnosis and management of Clostridium difficile-associated diarrhea and colitis. American College of Gastroenterology, Practice Parameters Committee. Am J Gastroenterol 1997; 92: 739-750
    PubMedGoogle Scholar
  • 55 DuPont HL. Guidelines on acute infectious diarrhea in adults. The Practice Parameters Committee of the American College of Gastroenterology. Am J Gastroenterol 1997; 92: 1962-1975
    PubMedGoogle Scholar
  • 56 Zuccaro GJr. Management of the adult patient with acute lower gastrointestinal bleeding. American College of Gastroenterology. Practice Parameters Committee. Am J Gastroenterol 1998; 93: 1202-1208
    CrossrefPubMedGoogle Scholar
  • 57 Lightdale CJ. Esophageal cancer. American College of Gastroenterology. Am J Gastroenterol 1999; 94: 20-29
    CrossrefPubMedGoogle Scholar
  • 58 Stollman NH, Raskin JB. Diagnosis and management of diverticular disease of the colon in adults. Ad Hoc Practice Parameters Committee of the American College of Gastroenterology. Am J Gastroenterol 1999; 94: 3110-3121
    CrossrefPubMedGoogle Scholar
  • 59 Vaezi MF, Richter JE. Diagnosis and management of achalasia. American College of Gastroenterology Practice Parameter Committee. Am J Gastroenterol 1999; 94: 3406-3412
    CrossrefPubMedGoogle Scholar
  • 60 Kornbluth A, Sachar DB. Ulcerative colitis practice guidelines in adults (update): American College of Gastroenterology, Practice Parameters Committee. Am J Gastroenterol 2004; 99: 1371-1385
    CrossrefPubMedGoogle Scholar
  • 61 Rao SS. Diagnosis and management of fecal incontinence. American College of Gastroenterology Practice Parameters Committee. Am J Gastroenterol 2004; 99: 1585-1604
    CrossrefPubMedGoogle Scholar
  • 62 Talley NJ, Vakil N. Guidelines for the management of dyspepsia. Am J Gastroenterol 2005; 100: 2324-2337
    CrossrefPubMedGoogle Scholar
  • 63 Banks PA, Freeman ML. Practice guidelines in acute pancreatitis. Am J Gastroenterol 2006; 101: 2379-2400
    CrossrefPubMedGoogle Scholar
  • 64 Khalid A, Brugge W. ACG practice guidelines for the diagnosis and management of neoplastic pancreatic cysts. Am J Gastroenterol 2007; 102: 2339-2349
    Google Scholar
  • 65 Chey WD, Wong BC. American College of Gastroenterology guideline on the management of Helicobacter pylori infection. Am J Gastroenterol 2007; 102: 1808-1825
    CrossrefPubMedGoogle Scholar
  • 66 Garcia-Tsao G, Sanyal AJ, Grace ND et al. Prevention and management of gastroesophageal varices and variceal hemorrhage in cirrhosis. Am J Gastroenterol 2007; 102: 2086-2102
    CrossrefPubMedGoogle Scholar
  • 67 Hirano I, Richter JE. ACG practice guidelines: esophageal reflux testing. Am J Gastroenterol 2007; 102: 668-685
    CrossrefPubMedGoogle Scholar
  • 68 Wang KK, Sampliner RE. Updated guidelines 2008 for the diagnosis, surveillance and therapy of Barrett’s esophagus. Am J Gastroenterol 2008; 103: 788-797
    CrossrefPubMedGoogle Scholar
  • 69 Lichtenstein GR, Hanauer SB, Sandborn WJ. Management of Crohn’s disease in adults. Am J Gastroenterol 2009; 104: 465-483
    CrossrefPubMedGoogle Scholar
  • 70 Lanza FL, Chan FK, Quigley EM. Guidelines for prevention of NSAID-related ulcer complications. Am J Gastroenterol 2009; 104: 728-738
    CrossrefPubMedGoogle Scholar
  • 71 Sharma P, Kozarek R. Role of esophageal stents in benign and malignant diseases. Am J Gastroenterol 2010; 105: 258-273
    CrossrefPubMedGoogle Scholar
  • 72 Bitton A, Buie D, Enns R et al. Treatment of hospitalized adult patients with severe ulcerative colitis: Toronto consensus statements. Am J Gastroenterol 2012; 107: 179-194
    CrossrefPubMedGoogle Scholar
  • 73 Gallegos-Orozco JF, Foxx-Orenstein AE, Sterler SM et al. Chronic constipation in the elderly. Am J Gastroenterol 2012; 107: 18-25
    CrossrefPubMedGoogle Scholar
  • 74 Laine L, Jensen DM. Management of patients with ulcer bleeding. Am J Gastroenterol 2012; 107: 345-360
    CrossrefPubMedGoogle Scholar
  • 75 Beilenhoff U, Neumann CS, Biering H et al. ESGE/ESGENA guideline for process validation and routine testing for reprocessing endoscopes in washer-disinfectors, according to the European Standard prEN ISO 15883 parts 1, 4 and 5. Endoscopy 2007; 39: 85-94
    Article in Thieme ConnectPubMedGoogle Scholar
  • 76 Beilenhoff U, Neumann CS, Rey JF et al. ESGE-ESGENA guideline for quality assurance in reprocessing: microbiological surveillance testing in endoscopy. Endoscopy 2007; 39: 175-181
    Article in Thieme ConnectPubMedGoogle Scholar
  • 77 Beilenhoff U, Neumann CS, Rey JF et al. ESGE-ESGENA Guideline: cleaning and disinfection in gastrointestinal endoscopy. Endoscopy 2008; 40: 939-957
    Article in Thieme ConnectPubMedGoogle Scholar
  • 78 Pohl J, Delvaux M, Ell C et al. European Society of Gastrointestinal Endoscopy (ESGE) Guidelines: flexible enteroscopy for diagnosis and treatment of small-bowel diseases. Endoscopy 2008; 40: 609-618
    Article in Thieme ConnectPubMedGoogle Scholar
  • 79 Dumonceau JM, Riphaus A, Aparicio JR et al. European Society of Gastrointestinal Endoscopy, European Society of Gastroenterology and Endoscopy Nurses and Associates, and the European Society of Anaesthesiology Guideline: Non-anesthesiologist administration of propofol for GI endoscopy. Endoscopy 2010; 42: 960-974
    Article in Thieme ConnectPubMedGoogle Scholar
  • 80 Rey JF, Beilenhoff U, Neumann CS et al. European Society of Gastrointestinal Endoscopy (ESGE) guideline: the use of electrosurgical units. Endoscopy 2010; 42: 764-772
    Article in Thieme ConnectPubMedGoogle Scholar
  • 81 Ladas SD, Triantafyllou K, Spada C et al. European Society of Gastrointestinal Endoscopy (ESGE): Recommendations (2009) on clinical use of video capsule endoscopy to investigate small-bowel, esophageal and colonic diseases. Endoscopy 2010; 42: 220-227
    Article in Thieme ConnectPubMedGoogle Scholar
  • 82 Dumonceau JM, Polkowski M, Larghi A et al. Indications, results, and clinical impact of endoscopic ultrasound (EUS)-guided sampling in gastroenterology: European Society of Gastrointestinal Endoscopy (ESGE) clinical guideline. Endoscopy 2011; 43: 897-912
    Article in Thieme ConnectPubMedGoogle Scholar
  • 83 Boustiere C, Veitch A, Vanbiervliet G et al. Endoscopy and antiplatelet agents. European Society of Gastrointestinal Endoscopy (ESGE) guideline. . Endoscopy 2011; 43: 445-461
    Article in Thieme ConnectPubMedGoogle Scholar
  • 84 Dumonceau JM, Garcia-Fernandez FJ, Verdun FR et al. Radiation protection in digestive endoscopy: European Society of Digestive Endoscopy (ESGE) guideline. Endoscopy 2012; 44: 408-421
    Article in Thieme ConnectPubMedGoogle Scholar
  • 85 Polkowski M, Larghi A, Weynand B et al. Learning, techniques, and complications of endoscopic ultrasound (EUS)-guided sampling in gastroenterology: European Society of Gastrointestinal Endoscopy (ESGE) technical guideline. Endoscopy 2012; 44: 190-206
    Article in Thieme ConnectPubMedGoogle Scholar
  • 86 Spada C, Hassan C, Galmiche JP et al. Colon capsule endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) guideline. Endoscopy 2012; 44: 527-536
    Article in Thieme ConnectPubMedGoogle Scholar
  • 87 Dinis-Ribeiro M, Areia M, de Vries AC et al. Management of precancerous conditions and lesions in the stomach (MAPS): guideline from the European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter Study Group (EHSG), European Society of Pathology (ESP), and the Sociedade Portuguesa de Endoscopia Digestiva (SPED). Endoscopy 2012; 44: 74-94
    Article in Thieme ConnectPubMedGoogle Scholar
  • 88 Dumonceau JM, Delhaye M, Tringali A et al. Endoscopic treatment of chronic pancreatitis: European Society of Gastrointestinal Endoscopy (ESGE) clinical guideline. Endoscopy 2012; 44: 784-800
    Article in Thieme ConnectPubMedGoogle Scholar
  • 89 Dumonceau JM, Tringali A, Blero D et al. Biliary stenting: indications, choice of stents and results: European Society of Gastrointestinal Endoscopy (ESGE) clinical guideline. Endoscopy 2012; 44: 277-298
    Article in Thieme ConnectPubMedGoogle Scholar
  • 90 BSG guidelines for decontamination of equipment for gastrointestinal endoscopy. The report of a working party of the British Society of Gastroenterology Endoscopy Committee. London: British Society of Gastroenterology Endoscopy Committee 2003 Available from: http://www.bsg.org.uk/clinical-guidelines/endoscopy/guidelines-for-decontamination-of-equipment-for-gastrointestinal-endoscopy.html Accessed: 31 October 2012
    PubMedGoogle Scholar
  • 91 Sidhu R, Sanders DS, Morris AJ et al. Guidelines on small bowel enteroscopy and capsule endoscopy in adults. Gut 2008; 57: 125-136
    CrossrefPubMedGoogle Scholar
  • 92 Allison MC, Sandoe JA, Tighe R et al. Antibiotic prophylaxis in gastrointestinal endoscopy. Gut 2009; 58: 869-880
    CrossrefPubMedGoogle Scholar
  • 93 Cairns SR, Scholefield JH, Steele RJ et al. Guidelines for colorectal cancer screening and surveillance in moderate and high risk groups (update from 2002). Gut 2010; 59: 666-689
    CrossrefPubMedGoogle Scholar
  • 94 Goddard AF, Badreldin R, Pritchard DM et al. The management of gastric polyps. Gut 2010; 59: 1270-1276
    CrossrefPubMedGoogle Scholar
  • 95 Mowat C, Cole A, Windsor A et al. Guidelines for the management of inflammatory bowel disease in adults. Gut 2011; 60: 571-607
    CrossrefPubMedGoogle Scholar
  • 96 Allum WH, Blazeby JM, Griffin SM et al. Guidelines for the management of oesophageal and gastric cancer. Gut 2011; 60: 1449-1472
    CrossrefPubMedGoogle Scholar
  • 97 Andreyev HJ, Davidson SE, Gillespie C et al. Practice guidance on the management of acute and chronic gastrointestinal problems arising as a result of treatment for cancer. Gut 2011; 61: 179-192
    PubMedGoogle Scholar
  • 98 Goddard AF, James MW, McIntyre AS et al. Guidelines for the management of iron deficiency anaemia. Gut 2011; 60: 1309-1316
    CrossrefPubMedGoogle Scholar
  • 99 Ramage JK, Ahmed A, Ardill J et al. Guidelines for the management of gastroenteropancreatic neuroendocrine (including carcinoid) tumours (NETs). Gut 2012; 61: 6-32
    CrossrefPubMedGoogle Scholar
  • 100 Malfertheiner P, Megraud F, O’Morain CA et al. Management of Helicobacter pylori infection – the Maastricht IV/Florence Consensus Report. Gut 2012; 61: 646-664
    CrossrefPubMedGoogle Scholar
  • 101 Winawer S, Fletcher R, Rex D et al. Colorectal cancer screening and surveillance: clinical guidelines and rationale-Update based on new evidence. Gastroenterology 2003; 124: 544-560
    CrossrefPubMedGoogle Scholar
  • 102 Itkin M, DeLegge MH, Fang JC et al. Multidisciplinary practical guidelines for gastrointestinal access for enteral nutrition and decompression from the Society of Interventional Radiology and American Gastroenterological Association (AGA) Institute, with endorsement by Canadian Interventional Radiological Association (CIRA) and Cardiovascular and Interventional Radiological Society of Europe (CIRSE). Gastroenterology 2011; 141: 742-765
    CrossrefPubMedGoogle Scholar
  • 103 Lieberman DA, Rex DK, Winawer SJ et al. Guidelines for colonoscopy surveillance after screening and polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer. Gastroenterology 2012; 143: 844-857
    CrossrefPubMedGoogle Scholar
  • 104 Centre for Health Services Research, University of Newcastle upon Tyne. Dyspepsia: managing dyspepsia in adults in primary care. Newcastle upon Tyne: Centre for Health Services Research; 2004; Available from: http://www.nice.org.uk/nicemedia/pdf/CG017fullguideline.pdf Accessed: 31 October 2012
    PubMedGoogle Scholar
  • 105 Poston GJ, Tait D, O’Connell S et al. Diagnosis and management of colorectal cancer: summary of NICE guidance. BMJ 2011; 343: d6751
    CrossrefPubMedGoogle Scholar