The COVID-19 pandemic has had a profound impact on provision of endoscopy services globally as staff and real estate were repurposed. As we begin to recover from the pandemic, a cohesive international approach is needed, and guidance on how to resume endoscopy services safely to avoid unintended harm from diagnostic delays. The aim of these guidelines is to provide consensus recommendations that clinicians can use to facilitate the swift and safe resumption of endoscopy services. An evidence-based literature review was carried out on the various strategies used globally to manage endoscopy during the COVID-19 pandemic and control infection. A modified Delphi process involving international endoscopy experts was used to agree on the consensus statements. A threshold of 80% agreement was used to establish consensus for each statement. 27 of 30 statements achieved consensus after two rounds of voting by 34 experts. The statements were categorised as pre-endoscopy, during endoscopy and postendoscopy addressing relevant areas of practice, such as screening, personal protective equipment, appropriate environments for endoscopy and infection control precautions, particularly in areas of high disease prevalence. Recommendations for testing of patients and for healthcare workers, appropriate locations of donning and doffing areas and social distancing measures before endoscopy are unique and not dealt with by any other guidelines. This international consensus using a modified Delphi method to produce a series of best practice recommendations to aid the safe resumption of endoscopy services globally in the era of COVID-19.
- infectious disease
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PB and SS contributed equally.
Contributors PB* - Conception and design of study, constructed statements, critical revision of the manuscript. SS* - Literature review, reviewed statement construct, wrote manuscript. MJB, AA - Consensus participation, critical revision of the manuscript. JFB - Designed voting platform, analysed and compiled voting data. AR - Study design, constructed statements, critical revision of the manuscript. All other coauthors were voting members of the consensus group and contributed to the final revision of the manuscript. *Both PB and SS contributed equally to the manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests PB - Research support from Fujifilm Europe, Boston Scientific, Pentax and Olympus Medical. VRM - consultant and research support for Boston Scientific, Medtronic; consultant: Medivators, Interpace Diagnostics; honoraria/speakers bureau: Torax Medical/Ethicon; equity interest/stockholder: Capsovision.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement All data relevant to the study are included in the article.