TableA.13 Summary of articles examined after consultation feedback

ID and authorsResearch setting and year of studyStudy designSample sizeTopic of documentKey results and conclusionsLevel of evidenceQuality score (AGREE)
*These articles were cited in the text.
Barry et al941UK (data between 1995 and 2000)Comparative study110 PatientsCancer stagingSpecial interest radiology improves the perceived preoperative stage of gastric cancer2+57%
Bassi et al708UK (2000)Single centre retrospective study479 PatientsCost of IBD treatmentThe 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 costs2+66%
Carter et al584International (2004)GuidelinesNAManagement of IBDGuidelines commissioned by BSG for the management of IBD in adultsGuidelines55%
Rubin et al*136UK (NA)Retrospective case reviews568 PatientsEpidemiology and management of IBDPrevalence 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 patients366%
Axon*719International (NA)Review of evidenceNACancer surveillance in ulcerative colitisRegular 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 colitis441%
Lim et al*720UK (data between 1978–1990)Retrospective cohort study128 PatientsFollow up of patients with ulcerative colitisLow grade dysplasia diagnosis is not sufficiently reliable to justify prophylactic colectomy. Conservative management of established low grade dysplasia cases should not be rules out2+61%
Fullerton942International (projections for 2000)Economic evaluationNAEconomic impact of functional digestive disordersThe economic impact of functional GI disease is large. Economic estimates are useful in policy decision making for the allocation of healthcare resources350%
Robinson et al943UK (NA)RCT458 PatientsSelf help interventions for IBSIntroducing a self help guidebook results in a reduction in primary care consultations, a perceived reduction in symptoms, and significant health service savings2+68%
Provenzale et al704International (1980–1998)Literature review2157 Articles; 10 includedSpecialised and general GI careGastroenterologists may provide better care than other provider types for certain disorders.180%
Norton and Kamm944UK 2002DiscussionN/ASpecialist nurses in gastroenterologySpecialist 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 other5N/A
Robinson et al*681UK (NA)RCT203 PatientsUlcerative colitis careSelf 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 costs2+68%
Wade945UK 1983Observational comparative interview follow-up study215 Patients, 142 in district health authorities with stoma care nurses, 73 in districts without stoma care nursesPsychological symptoms in colostomy patients after surgery and the benefits of stoma care nursesShort 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 problems2−45%
Erwin-Toth and Spencer946USA, not given, published 1991Questionnaire follow-up of patients after ostomy surgery, convenience sample52 Volunteers were recruited, 39 completed forms were receivedPatient assessed quality of careHigh satisfaction but results limited by methodological weaknesses, acknowledged by authors2−29%
Maule758USA 1994 publishedProspective non-randomised controlled study1881 Intervention patients; 730 control patientsEffectiveness of screening for colorectal cancer by nurses compared with doctorsDepth 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-up2+57%
Moshakis et al*714UK Published 1996Comparative study50 Trainer and 50 pupil casesCompetence of nurses with training to undertake endoscopiesQuality 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*715USA Published 1999Randomised controlled trial162 Patients intervention group; 166 patients control groupAccuracy of polyp detection, depth of insertion and complication rate for flexible sigmoidoscopy: comparison of nurses and doctorsNo 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 gastroenterologists159%