Barry et al941 | UK (data between 1995 and 2000) | Comparative study | 110 Patients | Cancer staging | Special interest radiology improves the perceived preoperative stage of gastric cancer | 2+ | 57% |
Bassi et al708 | UK (2000) | Single centre retrospective study | 479 Patients | Cost of IBD treatment | The study represents the first detailed characterisation of the scale and determinants of costs of illness for IBD. Hospitalisation affected a minority of patients but accounted for half the total direct costs | 2+ | 66% |
Carter et al584 | International (2004) | Guidelines | NA | Management of IBD | Guidelines commissioned by BSG for the management of IBD in adults | Guidelines | 55% |
Rubin et al*136 | UK (NA) | Retrospective case reviews | 568 Patients | Epidemiology and management of IBD | Prevalence rates, but not incidence rates, for IBD are substantially higher than described in UK populations. GPs make a significant contribution to meeting the healthcare needs of these patients | 3 | 66% |
Axon*719 | International (NA) | Review of evidence | NA | Cancer surveillance in ulcerative colitis | Regular clinical follow-up is important. At 8–10 years after their first attack, total colonoscopy should be performed with multiple biopsy specimens to check for colitis | 4 | 41% |
Lim et al*720 | UK (data between 1978–1990) | Retrospective cohort study | 128 Patients | Follow up of patients with ulcerative colitis | Low grade dysplasia diagnosis is not sufficiently reliable to justify prophylactic colectomy. Conservative management of established low grade dysplasia cases should not be rules out | 2+ | 61% |
Fullerton942 | International (projections for 2000) | Economic evaluation | NA | Economic impact of functional digestive disorders | The economic impact of functional GI disease is large. Economic estimates are useful in policy decision making for the allocation of healthcare resources | 3 | 50% |
Robinson et al943 | UK (NA) | RCT | 458 Patients | Self help interventions for IBS | Introducing a self help guidebook results in a reduction in primary care consultations, a perceived reduction in symptoms, and significant health service savings | 2+ | 68% |
Provenzale et al704 | International (1980–1998) | Literature review | 2157 Articles; 10 included | Specialised and general GI care | Gastroenterologists may provide better care than other provider types for certain disorders. | 1 | 80% |
Norton and Kamm944 | UK 2002 | Discussion | N/A | Specialist nurses in gastroenterology | Specialist nurses can take on some tasks traditionally carried out by doctors, although evidence concerning safety and effectiveness is lacking. It is not necessarily cheaper to substitute nurses for doctors. A multidisciplinary approach is advocated, in which the skills of one professional group are complemented by the skills of the other | 5 | N/A |
Robinson et al*681 | UK (NA) | RCT | 203 Patients | Ulcerative colitis care | Self management of ulcerative colitis accelerates treatment provision and reduces doctor visits, and does not increase morbidity. This approach could be used in long term management of many other chronic diseases to improve health service provision and use, and to reduce costs | 2+ | 68% |
Wade945 | UK 1983 | Observational comparative interview follow-up study | 215 Patients, 142 in district health authorities with stoma care nurses, 73 in districts without stoma care nurses | Psychological symptoms in colostomy patients after surgery and the benefits of stoma care nurses | Short term outcomes were improved in the stoma care district patients, although there were no differences at one year. 10% of patients who reported that they were well were anxious or depressed. Physical symptoms were associated with psychiatric morbidity. Psychiatric referral was suggested to be inappropriate, as medical referral may be more helpful in resolving problems | 2− | 45% |
Erwin-Toth and Spencer946 | USA, not given, published 1991 | Questionnaire follow-up of patients after ostomy surgery, convenience sample | 52 Volunteers were recruited, 39 completed forms were received | Patient assessed quality of care | High satisfaction but results limited by methodological weaknesses, acknowledged by authors | 2− | 29% |
Maule758 | USA 1994 published | Prospective non-randomised controlled study | 1881 Intervention patients; 730 control patients | Effectiveness of screening for colorectal cancer by nurses compared with doctors | Depth of insertion of sigmoidoscope was greater in those examined by doctors. There was no difference in the proportion of examinations that were positive for adenomas or cancer. A higher proportion of patients whose examination was normal and were examined by nurses returned for follow-up | 2+ | 57% |
Moshakis et al*714 | UK Published 1996 | Comparative study | 50 Trainer and 50 pupil cases | Competence of nurses with training to undertake endoscopies | Quality and accuracy were assessed as equal between groups, with 60 cm insertion achieved in a similar number of cases. Nurses can be taught to practise flexible sigmoidoscopy efficiently and safely. | 2− | 23% |
Schoenfeld et al*715 | USA Published 1999 | Randomised controlled trial | 162 Patients intervention group; 166 patients control group | Accuracy of polyp detection, depth of insertion and complication rate for flexible sigmoidoscopy: comparison of nurses and doctors | No differences in detection of polyps or frequency of complications were found, suggesting nurse endoscopists may perform screening flexible sigmoidoscopy as safely and as effectively as gastroenterologists | 1 | 59% |