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News

British guidelines for the management of large non-pedunculated colorectal polyps

The British Society of Gastroenterology/Association of Coloproctologists of Great Britain and Ireland developed guidelines for the management of large non-pedunculated colorectal polyps, reports the latest issue of Gut.

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These guidelines provide an evidence-based framework for the management of patients with large non-pedunculated colorectal polyps, in addition to identifying key performance indicators that permit the audit of quality outcomes.

These are areas not previously covered by British Society of Gastroenterology (BSG) Guidelines.

A National Institute of Health and Care Excellence (NICE) compliant BSG guideline development process was used throughout and the Appraisal of Guidelines for Research and Evaluation (AGREE II) tool was used to structure the guideline development process.

Professor Rutter and colleagues performed a systematic review of literature for English language articles up to 2014 concerning the assessment and management of large non-pedunculated colorectal polyps.

The team developed key performance indicators for the management of large non-pedunculated colorectal polyps
Gut

The research team assessed the quality of evaluated studies using the Scottish Intercollegiate Guidelines Network (SIGN) Methodology Checklist System.

The team evaluated proposed recommendation statements by each member of the Guideline Development Group (GDG) on a scale from 1 (strongly agree) to 5 (strongly disagree) with >80% agreement required for consensus to be reached.

Where consensus was not reached a modified Delphi process was used to re-evaluate and modify proposed statements until consensus was reached or the statement discarded.

A round table meeting was subsequently held to finalize recommendations, and to evaluate the strength of evidence discussed.

The GRADE tool was used to assess the strength of evidence and strength of recommendation for finalised statements.

The researchers also developed key performance indicators, a training framework and potential research questions for the management of large non-pedunculated colorectal polyps.

Professor Rutter and team comment, "It is hoped that these guidelines will improve the assessment and management of large non-pedunculated colorectal polyps."

Gut 2015;64:1847-1873
16 November 2015

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