Study Authors 

Jonathan Moses, Kelly Sandberg, Gabriel Winberry, Diana Riera, Sarah DeLozier, Sandeep K Gupta, Norelle Reilly, K T Park, Joseph Picoraro

Study Background 

As a community of physicians, our practice has shifted towards following not just symptoms, but assessing the lining of the gut to see if there is healing when judging medication effectiveness, so called “mucosal healing” or endoscopic remission. There are data suggesting patients with IBD who achieve endoscopic remission have better long-term outcomes, such as longer time spent in remission and less hospitalizations/surgeries. Although this practice has become commonplace in the care of adults with IBD, it is unclear how often this practice of repeat endoscopy after starting a new medication is being used in pediatric IBD. Given this is a clinical practice survey, having access to the providers directly to participate was a key to our success. Using the ICN Listserv to contact providers directly allowed us to collect data on practice patterns for this study. In addition, the ICN Research Committee provided invaluable scientific oversight of our study design.

Study Overview 

The aim of our study was to assess the use of repeat endoscopy after the start of a new medication using a clinical practice survey targeted to practicing pediatric gastroenterologists. We also aimed to examine any factors related to the providers that may affect whether or not they repeat endoscopy routinely. Primarily pediatric gastroenterologists who would be making the decision on the need for repeat endoscopy completed the survey. The results of this study helped us better understand how often pediatric gastroenterologists repeat endoscopy, which was previously unknown. One of the limitations of the study was the low response rate, which may limit how generalizable the data is across the ICN community. We also did not include patient and parental views on repeat endoscopy.

Study Results - What does it all mean? 

Prior to completing this study, we did not have a good understanding of how often pediatric gastroenterologist utilized repeat endoscopy in their clinical practice. Looking at the results of the clinical practice survey, we found a high rate of respondents (68% of them) do use repeat endoscopy, and they tended to be in practice for fewer years (1-10 years) than those who did not repeat endoscopy (greater than 15 years). We hope this data is able to support future efforts to examine the long-term outcomes of children and adolescents with IBD who achieve endoscopic remission. We would also hope future studies include patients and parents in the study design and results to better understand their thoughts on the need for repeat endoscopy in routine clinical care.

Study status

As of February 24, 2021, this study has been published online ahead of print in the Journal of Pediatric Gastroenterology and Nutrition. It has been added to our list of published research studies. You can view our community's published research by visiting our Publications page >>

Prepared by: Jonathan Moses, MD
Reviewed by: Parent Working Group Research Subcommittee
About ICN Research Explained: We believe that in order to truly outsmart IBD, the questions we ask and the answers we find must be generated by and be useful to the people whose lives they will impact – patients and their families. ImproveCareNow (ICN) research is prioritized based on what matters most to patients and parents, and we are committed to sharing our results so everyone can understand and take advantage of what’s been learned. The ICN Research Committee has teamed up with the Parent Working Group Research Subcommittee to create and share parent-approved research summaries called “ICN Research Explained."
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