Browsing by Author "Francis, Nader K."

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    EAES and SAGES 2018 consensus conference on acute diverticulitis management: evidence-based recommendations for clinical practice
    (Springer Nature, 2019-09) Francis, Nader K.; Sylla, Patricia; Abou-Khalil, Maria; Arolfo, Simone; Berler, David; Curtis, Nathan J.; Dolejs, Scott C.; Garfinkle, Richard; Gorter-Stam, Marguerite; Hashimoto, Daniel A.; Hassinger, Taryn E.; Molenaar, Charlotte J. L.; Pucher, Philip H.; Schuermans, Valérie; Arezzo, Alberto; Agresta, Ferdinando; Antoniou, Stavros A.; Arulampalam, Tan; Boutros, Marylise; Bouvy, Nicole; Campbell, Kenneth; Francone, Todd; Haggerty, Stephen P.; Hedrick, Traci L.; Stefanidis, Dimitrios; Truitt, Mike S.; Kelly, Jillian; Ket, Hans; Dunkin, Brian J.; Pietrabissa, Andrea; Surgery, School of Medicine
    BACKGROUND: Acute diverticulitis (AD) presents a unique diagnostic and therapeutic challenge for general surgeons. This collaborative project between EAES and SAGES aimed to summarize recent evidence and draw statements of recommendation to guide our members on comprehensive AD management. METHODS: Systematic reviews of the literature were conducted across six AD topics by an international steering group including experts from both societies. Topics encompassed the epidemiology, diagnosis, management of non-complicated and complicated AD as well as emergency and elective operative AD management. Consensus statements and recommendations were generated, and the quality of the evidence and recommendation strength rated with the GRADE system. Modified Delphi methodology was used to reach consensus among experts prior to surveying the EAES and SAGES membership on the recommendations and likelihood to impact their practice. Results were presented at both EAES and SAGES annual meetings with live re-voting carried out for recommendations with < 70% agreement. RESULTS: A total of 51 consensus statements and 41 recommendations across all six topics were agreed upon by the experts and submitted for members' online voting. Based on 1004 complete surveys and over 300 live votes at the SAGES and EAES Diverticulitis Consensus Conference (DCC), consensus was achieved for 97.6% (40/41) of recommendations with 92% (38/41) agreement on the likelihood that these recommendations would change practice if not already applied. Areas of persistent disagreement included the selective use of imaging to guide AD diagnosis, recommendations against antibiotics in non-complicated AD, and routine colonic evaluation after resolution of non-complicated diverticulitis. CONCLUSION: This joint EAES and SAGES consensus conference updates clinicians on the current evidence and provides a set of recommendations that can guide clinical AD management practice.
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    Guideline Assessment Project II: statistical calibration informed the development of an AGREE II extension for surgical guidelines
    (Springer, 2021-08) Tsokani, Sofia; Antoniou, Stavros A.; Moustaki, Irini; López-Cano, Manuel; Antoniou, George A.; Flórez, Ivan D.; Silecchia, Gianfranco; Markar, Sheraz; Stefanidis, Dimitrios; Zanninotto, Giovanni; Francis, Nader K.; Hanna, George H.; Morales-Conde, Salvador; Bonjer, Hendrik Jaap; Brouwers, Melissa C.; Mavridis, Dimitrios; Surgery, School of Medicine
    OBJECTIVE: To inform the development of an AGREE II extension specifically tailored for surgical guidelines. AGREE II was designed to inform the development, reporting, and appraisal of clinical practice guidelines. Previous research has suggested substantial room for improvement of the quality of surgical guidelines. METHODS: A previously published search in MEDLINE for clinical practice guidelines published by surgical scientific organizations with an international scope between 2008 and 2017, resulted in a total of 67 guidelines. The quality of these guidelines was assessed using AGREE II. We performed a series of statistical analyses (reliability, correlation and Factor Analysis, Item Response Theory) with the objective to calibrate AGREE II for use specifically in surgical guidelines. RESULTS: Reliability/correlation/factor analysis and Item Response Theory produced similar results and suggested that a structure of 5 domains, instead of 6 domains of the original instrument, might be more appropriate. Furthermore, exclusion and re-arrangement of items to other domains was found to increase the reliability of AGREE II when applied in surgical guidelines. CONCLUSIONS: The findings of this study suggest that statistical calibration of AGREE II might improve the development, reporting, and appraisal of surgical guidelines.