CC BY-NC-ND 4.0 · Endosc Int Open 2020; 08(05): E693-E698
DOI: 10.1055/a-1153-9014
Original article

What constitutes urgent endoscopy? A social media snapshot of gastroenterologists’ views during the COVID-19 pandemic

Mohammad Bilal
1  Center for Advanced Endoscopy, Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States
,
Malorie Simons
2  Division of Gastroenterology & Hepatology, Johns Hopkins Hospital, Baltimore, Maryland, United States
,
Asad Ur Rahman
3  Department of Gastroenterology & Hepatology, Cleveland Clinic Florida, Weston, Florida, United States
,
Zachary L. Smith
4  Division of Gastroenterology and Liver Disease, University Hospitals & Case Western Reserve University School of Medicine, Cleveland, Ohio, United States
,
Shifa Umar
5  Division of Gastroenterology & Hepatology, Allegheny Health Network, Pittsburgh, Pennsylvania, United States
,
Jonah Cohen
1  Center for Advanced Endoscopy, Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States
,
Mandeep S. Sawhney
1  Center for Advanced Endoscopy, Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States
,
Tyler M. Berzin
1  Center for Advanced Endoscopy, Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States
,
Douglas K. Pleskow
1  Center for Advanced Endoscopy, Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States
› Author Affiliations
  

Abstract

Background and study aims There is a consensus among gastroenterology organizations that elective endoscopic procedures should be deferred during the COVID-19 pandemic. While the decision to perform urgent procedures and to defer entirely elective procedures is mostly evident, there is a wide “middle ground” of time-sensitive but not technically urgent or emergent endoscopic interventions. We aimed to survey gastroenterologists worldwide using Twitter to help elucidate these definitions using commonly encountered clinical scenarios during the COVID-19 pandemic.

Methods A 16-question survey was designed by the authors to include common clinical scenarios that do not have clear guidelines regarding the timing or urgency of endoscopic evaluation. This survey was posted on Twitter. The survey remained open to polling for 48 hours. During this time, multiple gastroenterologists and fellows with prominent social media presence were tagged to disseminate the survey.

Results The initial tweet had 38,795 impressions with a total of 2855 engagements. There was significant variation in responses from gastroenterologists regarding timing of endoscopy in these semi-urgent scenarios. There were only three of 16 scenarios for which more than 70 % of gastroenterologists agreed on procedure-timing. For example, significant variation was noted in regard to timing of upper endoscopy in patients with melena, with 44.5 % of respondents believing that everyone with melena should undergo endoscopic evaluation at this time. Similarly, about 35 % of respondents thought that endoscopic retrograde cholangiopancreatography should only be performed in patients with choledocholithiasis with abdominal pain or jaundice.

Conclusion Our analysis shows that there is currently lack of consensus among gastroenterologists in regards to timing of semi-urgent or non-life-threatening procedures during the COVID-19 pandemic. These results support the need for the ongoing development of societal guidance for these “semi-urgent” scenarios to help gastroenterologists in making difficult triage decisions.



Publication History

Received: 02 April 2020

Accepted: 03 April 2020

Publication Date:
17 April 2020 (online)

© 2020. Owner and Copyright ©

© Georg Thieme Verlag KG
Stuttgart · New York