Quality of Care Initiatives

European Rapid Guideline on transanal total mesorectal excision for rectal cancer: UEG and EAES recommendations

Brief description of the initiative: The objective of this rapid guideline is to develop reliable, trustworthy, pertinent, evidence-informed recommendations based on state-of-the art guideline development methodology on the use of TaTME versus laparoscopic or robotic surgery in patients with rectal cancer.

Project type: Guideline development
Participating UEG Member Societies: EAES
Lead Coordinator:
Project outcome: UEG and EAES rapid guideline: Systematic review, meta-analysis, GRADE assessment and evidence-informed European recommendations on TaTME for rectal cancer

European Rapid Guideline on surgical management of gastroesophageal reflux disease – UEG and EAES recommendations

Brief description of the initiative: This rapid guideline aims to provide transparently developed, reliable, and evidence-informed recommendations on the different treatment options in GERD employing latest evidence synthesis methods by means of network meta-analysis and using a multiple-treatments evidence-to-decision framework.

Project type: Guideline development
Participating UEG Member Societies: EAES
Lead Coordinator:

European Guideline on prevention, assessment and treatment of surgical site infections following digestive surgery – UEG, ESCP, EAES, and SIS-E consensus

Brief description of the initiative: The aim of this joint project is to provide guidance on prevention, assessment, and management of surgical site infections after digestive surgery. An international panel, including patient representatives, will develop guidelines following rigorous guideline development methodology. The objective is to generate a solid and practical pathway that can be implemented at a global level, allowing to reduce the impact of surgical site complications on healthcare systems and on patients’ safety and wellbeing.

Project type: Guideline development
Participating UEG Member Societies: ESCP, EAES, SIS-E, ESNO
Lead Coordinator:

European Guideline on the Diagnosis and Therapy of Pancreatic Exocrine Insufficiency - UEG, EPC, EDS, ESPGHAN, ESPEN, ESDO and ESPCG Recommendations

Brief description of the initiative: Pancreatic exocrine insufficiency (PEI) is a frequent and clinically relevant complication of different pancreatic and extra-pancreatic diseases and conditions. There is a wide variability in the diagnostic and therapeutic approach to this condition in different clinical scenarios and different centres across Europe and outside Europe. Under the umbrella of the UEG, and with the participation of the different European Societies dealing with patients with PEI, the present guideline intends to harmonize the diagnosis and clinical management of PEI secondary to pancreatic and extra-pancreatic diseases and conditions across Europe, and to identify the gaps of knowledge in this field.

Project type: Guideline development
Participating UEG Member Societies: EPC, EDS, ESPGHAN, ESPEN, ESDO, ESPCG
Lead Coordinator:

European Guideline on Bloating and Abdominal Distension – UEG, ESNM, EAGEN, ESPCG, BSGE, RSGH & HGD Recommendations

Brief description of the initiative: The group will propose statements on the prevalence, symptom presentation, diagnosis, pathophysiology, complications, and management of bloating and abdominal distention. For each topic, a systematic literature survey will be available on an online access point. A Delphi consensus process (80% agreement threshold) by GRADE will be used to categorize the quality of evidence and strength of recommendations.

Project type: Guideline development
Participating UEG Member Societies: UEG, ESNM, EAGEN, ESPCG, Bulgarian Society of Gastroenterology (BSGE), Romanian Society of Gastroenterology & Hepatology (RSGH) & Hrvatsko gastroenterološko društvo (HGD)
Lead Coordinator:

European Clinical Practice Guideline on Malabsorption – UEG and SIGE, LGA, SPG, SRGH, CGS, EAGEN, ESPEN, ESPGHAN guideline

Brief description of the initiative: Although malabsorption and malabsorption syndromes are rather common, no guideline for their recognition and proper diagnostic work-up exists. The aims of the guideline will be achieved through multiple rounds of online meetings, taking into account the open issues to be addressed, including the definition of malabsorption, its diagnostic criteria, and its clinical phenotypes. A final algorithm which combines screening tests, laboratory, and endoscopic or radiological tests for early recognition will be provided.

Project type: Guideline development
Participating UEG Member Societies: SIGE (Italy), LGA (Latvia), SPG (Portugal), SRGH (Romania), CGS (Czech Republic), EAGEN, ESPEN, ESPGHAN, ESPCG
Lead Coordinators:

European Guideline on Nausea and Vomiting – UEG and ESNM consensus for clinical management

Brief description of the initiative: Nausea and vomiting are symptoms which commonly present to the GI specialist and general practitioner. The differential diagnosis is wide, including digestive and non-digestive etiologies, organic and functional disorders. Recent progress in the scientific knowledge of specific causes of nausea and vomiting make this guideline particularly timely. We aim to develop a European guideline including a systematic, well-structured approach to obtain a valid diagnosis and to guide management of nausea and vomiting through the concerted effort of gastroenterologists, surgeons, and primary care physicians from a broad spectrum of countries across Europe.

Project type: Guideline development
Participating UEG Member Societies: ESNM
Lead Coordinator:

AGREE II Extension for Surgical Guidelines: UEG and EAES consensus

Brief description of the initiative: The aims of this project are to assess the quality of clinical practice guidelines (CPGs) in surgery and to propose a framework for improvement and to develop an AGREE II instrument extension that is specific for surgery through an evidence-informed and consensus-based approach.

Project type: Guideline development
Participating UEG Member Societies: EAES
Lead Coordinator:
Project outcome: AGREE-S: AGREE II extension for surgical interventions

Read more in UEG Journal

Current application of the European evidence-based guidelines on pancreatic cystic tumours

Brief description of the initiative: A survey and retrospective analysis will be conducted to assess the real application of the European evidence-based guidelines on pancreatic cystic neoplasms among European countries. To help disseminate the existing guidelines about pancreatic cystic neoplasms management a mobile app will be developed, helping clinicians, especially from low volume centres taking evidence-based decisions about their patients.

Project type: Guideline dissemination
Participating UEG Member Societies: EDS, Romania, ESGAR, Italy (SIGE)
Lead Coordinator: 
Project outcome: icyst App, available on Apple Store and Google Play
 

European Guideline on faecal incontinence – UEG and ESCP/ESNM/ESPCG guideline

Brief description of the initiative: The guidelines will provide guidance on the most effective treatment and management of patients with FI. By providing this information, we specifically aim to improve treatment outcomes and patient satisfaction. The development of the guideline will be based on internationally recognized guideline development methodology. These include criteria of quality, as detailed in the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument, primary methodological research and evaluation undertaken by the guideline development group (GDG).

Project type: Guideline development
Participating UEG Member Societies: ESCP, ESPCG, ESNM
Lead Coordinator:
Project outcome: Guideline for the diagnosis and treatment of Faecal Incontinence, GI Guidelines Webinar, available in GI Guidelines App

Read more in UEG Journal

European Guideline on Functional Chronic Diarrhoea – UEG and ESNM, SIGE, RSGH and TSG Recommendations

Brief description of the initiative: The group will propose statements on the prevalence, symptom presentation, diagnosis, pathophysiology, complications and management of functional chronic diarrhoea. For each topic, a systematic literature survey will be available on an online access point. A Delphi consensus process (80% agreement threshold) by GRADE (Grading of Recommendations Assessment, Development and Evaluation) will be used to categorize the quality of evidence and strength of recommendations.

Project type: Guideline development
Participating UEG Member Societies: ESNM, Italy (SIGE), Romania, Turkey
Lead Coordinator:
Project outcome: Functional bowel disorders with diarrhoea: Clinical guidelines of the United European Gastroenterology and European Society for Neurogastroenterology and Motility, available in GI Guidelines App 

Read more in UEG Journal 

European Guideline on indication, performance and clinical impact of H2CH4- and 13C-breath test in adult and paediatric patients: consensus European guideline by EAGEN in collaboration with ESNM, ESPGHAN and several National Societies

Brief description of the initiative: A guideline will be developed to define the clinical indications, performance and rational interpretation of breath tests (H2, CH4 and 13C-breath tests) in adult and paediatric patients. The topic of the guideline will address, in large part functional bloating and diarrhoea. Specifically, it will provide recommendations for the use of breath tests in the evaluation of patients with these symptoms, which are a very common reason for attendance in gastroenterological and in general medical practices.

Project type: Guideline development
Participating UEG Member Societies: EAGEN, ESNM, ESPGHAN, Austria, Bulgaria, Germany, Hungary, Italy, Romania
Lead Coordinator:
Project outcome: European guideline on indications, performance, and clinical impact of hydrogen and methane breath tests in adult and pediatric patients, European guideline on indications, performance and clinical impact of 13C-breath tests in adult and pediatric patients, GI Guidelines Webinar, available in GI Guidelines App (hydrogen and methane breath test, 13C-breath test)

European Guideline on obesity care in patients with GI and liver diseases – UEG and ESPEN guideline

Brief description of the initiative: The scope of this obesity guideline will cover the following topics: patients with IBD, patients with IBS, patients with chronic liver disease (mostly NAFLD and liver transplant) and will be developed according to the standard operating procedure for ESPEN guidelines.

Project type: Guideline development
Participating UEG Member Societies: ESPEN, ECCO, ESNM, EASL
Lead Coordinator: 
Project outcome: European guideline on obesity care in patients with gastrointestinal and liver diseases 

Read more in UEG Journal 

Translating FMT applications related to Clostridium difficile infection into the local clinical practice

Brief description of the initiative: The aim is to implement FMT for refractory and recurrent CDI in Romania and to create national guidelines in this regard in Romania and Hungary, following the recommendations of the European Consensus on FMT in clinical practice, taking into account local conditions and adapting the currently available guideline of the British Society of Gastroenterology and Healthcare Infection Society and European consensus conference on faecal microbiota transplantation in clinical practice. Moreover, following this initiative, stool banking can be consequently developed and the extension and adaptation of FMT for paediatric use in local conditions could also be established.

Project type: Guideline dissemination
Participating UEG Member Societies: Romania, Hungary, EHMSG, UK
Lead Coordinator:

Achalasia: Diagnosis, treatment and follow-up

Brief description of the initiative: This multidisciplinary guideline will aim to provide an evidence-based framework with recommendations on the diagnosis, treatment and follow-up of adult achalasia patients. This guideline is intended for clinicians involved in their management, including gastroenterologists, endoscopists, radiologists, gastrointestinal surgeons, dietitians and primary care practitioners. (Project completed)
Project type: Guideline development
Participating UEG Member Societies: ESNM, EAES, ESGAR
Lead Coordinator:
Project outcome: European guidelines on achalasia, GI Guidelines Webinar, available in GI Guidelines App

Read more in UEG Journal

Clinical guidelines for the management of chronic mesenteric ischemia

Brief description of the initiative: With the development of a multidisciplinary guideline on CMI we aim to provide a compressive overview and repository of the current evidence and agreement on pertinent issues pertaining the diagnosis and treatment of CMI to guide physicians working in the multidisciplinary field of gastrointestinal diseases in the management of their patients and improve treatment outcome.
Project type: Guideline development
Participating UEG Member Societies: EAGEN, ESGAR, Netherlands Association of Hepatogastroenterologists (NVMDL), Hellenic Society of Gastroenterology
Lead Coordinator:  
Project outcome: European guidelines on chronic mesenteric ischaemia, GI Guidelines Webinar, available in GI Guidelines App

Read more in UEG Journal

European GI motility hub

Brief description of the initiative: The European GI Motility Hub initiative proposes an innovative on-line platform to disseminate guidelines and provide practical training that will help minimize disparities between centres and health care systems and, it is hoped, add significantly to the welfare of GI patients throughout Europe.

Project type: Guideline dissemination
Participating UEG Member Societies: ESCP, ESPGHAN, Turkish Society of Gastroenterology, German Society of Gastroenterology (DGVS)
Lead Coordinator:
Project outcome: EUIGM Hub Website

Visit EUGIM Hub

European guideline on the management of microscopic colitis

Brief description of the initiative: In order to harmonize and standardize the clinical management of MC across Europe, a pan-European Clinical Practice Guideline on MC is essential. Topics: MC concept and epidemiology, aetiology and pathogenesis, clinical manifestation, diagnosis, histopathology, treatment.

Project type: Guideline development
Participating UEG Member Societies: German Society of Gastroenterology (DGVS), Swedish Society of Gastroenterology, Lithuanian Society of Gastroenterology, Hungarian Society of Gastroenterology, Danish Society of Gastroenterology and Hepatology, Netherlands Association of Hepatogastroenterologists (NVMDL), Spanish Society of Gastroenterology (AEG), ESP
Lead Coordinator:
Project outcome: European guidelines on microscopic colitis, GI Guidelines Webinar, UEG Journal Podcast, available in GI Guidelines App

Read more in UEG Journal
 

Functional dyspepsia & gastroparesis

Brief description of the initiative: Development of guidelines following a 3-step approach: (1) Collection and review of FD&GP guidelines available in Europe and beyond, (2) Conductance of a (PICA-based) consensus process within the working group for a transnational FD&GP clinical guideline and (3) Initiation of national consensus and agreement processes for approval of the final guideline.

Project type: Guideline development
Participating UEG Member Society: ESNM
Lead Coordinator:
Project outcome: Consensus on functional dyspepsia, Consensus on gastroparesis, GI Guidelines Webinar, available in GI Guidelines App (functional dyspepsia, gastroparesis)

IgG4-related GI diseases

Brief description of the initiative: IgG4-related diseases represents a syndrome of a wide variety of diseases. We will follow the GRADE system, successfully applied to the IAP/APA guidelines on acute pancreatitis, the UEG/HaPanEU guidelines on chronic pancreatitis, and most recently the European guidelines on pancreatic cystic neoplasms.

Project type: Guideline development
Participating UEG Member Societies: Swedish Society of Gastroenterology, Ukrainian Gastroenterological Association, Danish Society of Gastroenterology and Hepatology, Romanian Society of Gastroenterology and Hepatology, German Society of Gastroenterology (DGVS), Turkish Society of Gastroenterology, Netherlands Association of Hepatogastroenterologists (NVMDL), British Society of Gastroenterology (BSG), ESGAR, EPC, Italian Society of Gastroenterology (SIGE), French Society of Gastroenterology (SNFGE)
Lead Coordinator:
Project outcome: European Guideline on IgG4-related digestive disease, GI Guidelines Webinar, available in GI Guidelines App

Read more in UEG Journal 

Spreading knowledge on malnutrition across Europe

Brief description of the initiative: The purpose of the initiative is to promote and disseminate existing clinical practice guidelines on malnutrition, especially in GI diseases (malnutrition in general, in IBD, in visceral surgery, in chronic intestinal failure, in liver disease, in oncology).
Project type: Guideline dissemination

The European Society for Clinical Nutrition and Metabolism launched its guideline on clinical nutrition in inflammatory bowel disease (IBD) as an app version with the support of UEG. The app is available for iOS and Android. 
Download ESPEN Guidelines App

Participating UEG Member Societies: ESPEN, Austrian Society of Gastroenterology and Hepatology (ÖGGH), Belgian Society of Gastroenterology (SRBGE), Croatian Society of Gastroenterology, German Society of Gastroenterology (DGVS), Macedonian Society of Gastroenterology, Gastrohepatology Association of Montenegro (GAM), Association of Serbian Gastroenterologists (ASG)
Lead Coordinator:
Project outcome: ESPEN Guidelines App, GI Guidelines Webinar

Visit ESPEN Website
 

Stool banking to facilitate safe and cost effective Fecal Microbiota Transplantation in Europe

Brief description of the initiative: To develop a European stool bank model based consensus report and qualified experience, creating a standard for implementation of FMT in Europe.

Project type: Guideline dissemination
Participating UEG Member Societies: EHMSG, Nederlandse Vereniging voor Gastro-Enterologie (NVGE), Ukrainian Gastroenterological Association
Lead Coordinator:
Project outcome: A standardised model for stool banking for faecal microbiota transplantation: a consensus report from a multidisciplinary UEG working group

Read more in UEG Journal