Biopsy Sampling in Upper Gastrointestinal Endoscopy: A Survey from 10 Tertiary Referral Centres across Europe

Jan Bornschein; Terry Tran-Nguyen; Gloria Fernandez-Esparrach; Stephen Ash; Francesc Balaguer; Elisabeth L. Bird-Lieberman; Henry Córdova; Zane Dzerve; Matteo Fassan; Marcis Leja; Ivan Lyutakov; Tim Middelburg; Leticia Moreira; Radislav Nakov; Stella A.V. Nieuwenburg; Anthony O'Connor; Stefano Realdon; Heiko De Schepper; Annemieke Smet; M. C.W. Spaander; Ivars Tolmanis; Tadas Urbonas; Jochen Weigt; Georgina L. Hold; Alexander Link; Juozas Kupcinskas

doi:10.1159/000511867

Biopsy Sampling in Upper Gastrointestinal Endoscopy: A Survey from 10 Tertiary Referral Centres across Europe

Jan Bornschein^*, Terry Tran-Nguyen, Gloria Fernandez-Esparrach, Stephen Ash, Francesc Balaguer, Elisabeth L. Bird-Lieberman, Henry Córdova, Zane Dzerve, Matteo Fassan, Marcis Leja, Ivan Lyutakov, Tim Middelburg, Leticia Moreira, Radislav Nakov, Stella A.V. Nieuwenburg, Anthony O'Connor, Stefano Realdon, Heiko De Schepper, Annemieke Smet, M. C.W. SpaanderIvars Tolmanis, Tadas Urbonas, Jochen Weigt, Georgina L. Hold, Alexander Link, Juozas Kupcinskas

^*Corresponding author for this work

Gastroenterology & Hepatology

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

Background: Guidelines give robust recommendations on which biopsies should be taken when there is endoscopic suggestion of gastric inflammation. Adherence to these guidelines often seems arbitrary. This study aimed to give an overview on current practice in tertiary referral centres across Europe. Methods: Data were collected at 10 tertiary referral centres. Demographic data, the indication for each procedure, endoscopic findings, and the number and sampling site of biopsies were recorded. Findings were compared between centres, and factors influencing the decision to take biopsies were explored. Results: Biopsies were taken in 56.6% of 9,425 procedures, with significant variation between centres (p < 0.001). Gastric biopsies were taken in 43.8% of all procedures. Sampling location varied with the procedure indication (p < 0.001) without consistent pattern across the centres. Fewer biopsies were taken in centres which routinely applied the updated Sydney classification for gastritis assessment (46.0%), compared to centres where this was done only upon request (75.3%, p < 0.001). This was the same for centres stratifying patients according to the OLGA system (51.8 vs. 73.0%, p < 0.001). More biopsies were taken in centres following the MAPS guidelines on stomach surveillance (68.1 vs. 37.1%, p < 0.001). Biopsy sampling was more likely in younger patients in 8 centres (p < 0.05), but this was not true for the whole cohort (p = 0.537). The percentage of procedures with biopsies correlated directly with additional costs charged in case of biopsies (r = 0.709, p = 0.022). Conclusion: Adherence to guideline recommendations for biopsy sampling at gastroscopy was inconsistent across the participating centres. Our data suggest that centre-specific policies are applied instead.

Original language	English
Pages (from-to)	179-189
Number of pages	11
Journal	Digestive Diseases
Volume	39
Issue number	3
DOIs	https://doi.org/10.1159/000511867
Publication status	Published - May 2021

Bibliographical note

Funding Information:
A. Link reports grants from European Commission “Eu-ropäischer Fond für regionale Entwicklung” (EFRE), outside the submitted work. In Lithuania the work was partly supported by Lithuanian Research Council Grant no APP-2/2016. In Latvia, the methodological support was made available from the project lzp-2018/1-0135. This work was also supported by the NIHR Oxford Biomedical Research Centre (The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care). In Barcelona, we thank the CERCA Programme/Generalitat de Catalunya for the support.

Publisher Copyright:
© 2020 The Author(s) Published by S. Karger AG, Basel.

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Bornschein, J., Tran-Nguyen, T., Fernandez-Esparrach, G., Ash, S., Balaguer, F., Bird-Lieberman, E. L., Córdova, H., Dzerve, Z., Fassan, M., Leja, M., Lyutakov, I., Middelburg, T., Moreira, L., Nakov, R., Nieuwenburg, S. A. V., O'Connor, A., Realdon, S., De Schepper, H., Smet, A., ... Kupcinskas, J. (2021). Biopsy Sampling in Upper Gastrointestinal Endoscopy: A Survey from 10 Tertiary Referral Centres across Europe. Digestive Diseases, 39(3), 179-189. https://doi.org/10.1159/000511867

@article{360e02772ee54faabe1c932dc3a367f4,

title = "Biopsy Sampling in Upper Gastrointestinal Endoscopy: A Survey from 10 Tertiary Referral Centres across Europe",

abstract = "Background: Guidelines give robust recommendations on which biopsies should be taken when there is endoscopic suggestion of gastric inflammation. Adherence to these guidelines often seems arbitrary. This study aimed to give an overview on current practice in tertiary referral centres across Europe. Methods: Data were collected at 10 tertiary referral centres. Demographic data, the indication for each procedure, endoscopic findings, and the number and sampling site of biopsies were recorded. Findings were compared between centres, and factors influencing the decision to take biopsies were explored. Results: Biopsies were taken in 56.6% of 9,425 procedures, with significant variation between centres (p < 0.001). Gastric biopsies were taken in 43.8% of all procedures. Sampling location varied with the procedure indication (p < 0.001) without consistent pattern across the centres. Fewer biopsies were taken in centres which routinely applied the updated Sydney classification for gastritis assessment (46.0%), compared to centres where this was done only upon request (75.3%, p < 0.001). This was the same for centres stratifying patients according to the OLGA system (51.8 vs. 73.0%, p < 0.001). More biopsies were taken in centres following the MAPS guidelines on stomach surveillance (68.1 vs. 37.1%, p < 0.001). Biopsy sampling was more likely in younger patients in 8 centres (p < 0.05), but this was not true for the whole cohort (p = 0.537). The percentage of procedures with biopsies correlated directly with additional costs charged in case of biopsies (r = 0.709, p = 0.022). Conclusion: Adherence to guideline recommendations for biopsy sampling at gastroscopy was inconsistent across the participating centres. Our data suggest that centre-specific policies are applied instead.",

author = "Jan Bornschein and Terry Tran-Nguyen and Gloria Fernandez-Esparrach and Stephen Ash and Francesc Balaguer and Bird-Lieberman, {Elisabeth L.} and Henry C{\'o}rdova and Zane Dzerve and Matteo Fassan and Marcis Leja and Ivan Lyutakov and Tim Middelburg and Leticia Moreira and Radislav Nakov and Nieuwenburg, {Stella A.V.} and Anthony O'Connor and Stefano Realdon and {De Schepper}, Heiko and Annemieke Smet and Spaander, {M. C.W.} and Ivars Tolmanis and Tadas Urbonas and Jochen Weigt and Hold, {Georgina L.} and Alexander Link and Juozas Kupcinskas",

note = "Funding Information: A. Link reports grants from European Commission “Eu-rop{\"a}ischer Fond f{\"u}r regionale Entwicklung” (EFRE), outside the submitted work. In Lithuania the work was partly supported by Lithuanian Research Council Grant no APP-2/2016. In Latvia, the methodological support was made available from the project lzp-2018/1-0135. This work was also supported by the NIHR Oxford Biomedical Research Centre (The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care). In Barcelona, we thank the CERCA Programme/Generalitat de Catalunya for the support. Publisher Copyright: {\textcopyright} 2020 The Author(s) Published by S. Karger AG, Basel.",

year = "2021",

month = may,

doi = "10.1159/000511867",

language = "English",

volume = "39",

pages = "179--189",

journal = "Digestive Diseases",

issn = "0257-2753",

publisher = "Karger",

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Bornschein, J, Tran-Nguyen, T, Fernandez-Esparrach, G, Ash, S, Balaguer, F, Bird-Lieberman, EL, Córdova, H, Dzerve, Z, Fassan, M, Leja, M, Lyutakov, I, Middelburg, T, Moreira, L, Nakov, R, Nieuwenburg, SAV, O'Connor, A, Realdon, S, De Schepper, H, Smet, A, Spaander, MCW, Tolmanis, I, Urbonas, T, Weigt, J, Hold, GL, Link, A & Kupcinskas, J 2021, 'Biopsy Sampling in Upper Gastrointestinal Endoscopy: A Survey from 10 Tertiary Referral Centres across Europe', Digestive Diseases, vol. 39, no. 3, pp. 179-189. https://doi.org/10.1159/000511867

TY - JOUR

T1 - Biopsy Sampling in Upper Gastrointestinal Endoscopy

T2 - A Survey from 10 Tertiary Referral Centres across Europe

AU - Bornschein, Jan

AU - Tran-Nguyen, Terry

AU - Fernandez-Esparrach, Gloria

AU - Ash, Stephen

AU - Balaguer, Francesc

AU - Bird-Lieberman, Elisabeth L.

AU - Córdova, Henry

AU - Dzerve, Zane

AU - Fassan, Matteo

AU - Leja, Marcis

AU - Lyutakov, Ivan

AU - Middelburg, Tim

AU - Moreira, Leticia

AU - Nakov, Radislav

AU - Nieuwenburg, Stella A.V.

AU - O'Connor, Anthony

AU - Realdon, Stefano

AU - De Schepper, Heiko

AU - Smet, Annemieke

AU - Spaander, M. C.W.

AU - Tolmanis, Ivars

AU - Urbonas, Tadas

AU - Weigt, Jochen

AU - Hold, Georgina L.

AU - Link, Alexander

AU - Kupcinskas, Juozas

N1 - Funding Information: A. Link reports grants from European Commission “Eu-ropäischer Fond für regionale Entwicklung” (EFRE), outside the submitted work. In Lithuania the work was partly supported by Lithuanian Research Council Grant no APP-2/2016. In Latvia, the methodological support was made available from the project lzp-2018/1-0135. This work was also supported by the NIHR Oxford Biomedical Research Centre (The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care). In Barcelona, we thank the CERCA Programme/Generalitat de Catalunya for the support. Publisher Copyright: © 2020 The Author(s) Published by S. Karger AG, Basel.

PY - 2021/5

Y1 - 2021/5

N2 - Background: Guidelines give robust recommendations on which biopsies should be taken when there is endoscopic suggestion of gastric inflammation. Adherence to these guidelines often seems arbitrary. This study aimed to give an overview on current practice in tertiary referral centres across Europe. Methods: Data were collected at 10 tertiary referral centres. Demographic data, the indication for each procedure, endoscopic findings, and the number and sampling site of biopsies were recorded. Findings were compared between centres, and factors influencing the decision to take biopsies were explored. Results: Biopsies were taken in 56.6% of 9,425 procedures, with significant variation between centres (p < 0.001). Gastric biopsies were taken in 43.8% of all procedures. Sampling location varied with the procedure indication (p < 0.001) without consistent pattern across the centres. Fewer biopsies were taken in centres which routinely applied the updated Sydney classification for gastritis assessment (46.0%), compared to centres where this was done only upon request (75.3%, p < 0.001). This was the same for centres stratifying patients according to the OLGA system (51.8 vs. 73.0%, p < 0.001). More biopsies were taken in centres following the MAPS guidelines on stomach surveillance (68.1 vs. 37.1%, p < 0.001). Biopsy sampling was more likely in younger patients in 8 centres (p < 0.05), but this was not true for the whole cohort (p = 0.537). The percentage of procedures with biopsies correlated directly with additional costs charged in case of biopsies (r = 0.709, p = 0.022). Conclusion: Adherence to guideline recommendations for biopsy sampling at gastroscopy was inconsistent across the participating centres. Our data suggest that centre-specific policies are applied instead.

AB - Background: Guidelines give robust recommendations on which biopsies should be taken when there is endoscopic suggestion of gastric inflammation. Adherence to these guidelines often seems arbitrary. This study aimed to give an overview on current practice in tertiary referral centres across Europe. Methods: Data were collected at 10 tertiary referral centres. Demographic data, the indication for each procedure, endoscopic findings, and the number and sampling site of biopsies were recorded. Findings were compared between centres, and factors influencing the decision to take biopsies were explored. Results: Biopsies were taken in 56.6% of 9,425 procedures, with significant variation between centres (p < 0.001). Gastric biopsies were taken in 43.8% of all procedures. Sampling location varied with the procedure indication (p < 0.001) without consistent pattern across the centres. Fewer biopsies were taken in centres which routinely applied the updated Sydney classification for gastritis assessment (46.0%), compared to centres where this was done only upon request (75.3%, p < 0.001). This was the same for centres stratifying patients according to the OLGA system (51.8 vs. 73.0%, p < 0.001). More biopsies were taken in centres following the MAPS guidelines on stomach surveillance (68.1 vs. 37.1%, p < 0.001). Biopsy sampling was more likely in younger patients in 8 centres (p < 0.05), but this was not true for the whole cohort (p = 0.537). The percentage of procedures with biopsies correlated directly with additional costs charged in case of biopsies (r = 0.709, p = 0.022). Conclusion: Adherence to guideline recommendations for biopsy sampling at gastroscopy was inconsistent across the participating centres. Our data suggest that centre-specific policies are applied instead.

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U2 - 10.1159/000511867

DO - 10.1159/000511867

M3 - Article

C2 - 33002891

AN - SCOPUS:85106540229

SN - 0257-2753

VL - 39

SP - 179

EP - 189

JO - Digestive Diseases

JF - Digestive Diseases

IS - 3

ER -

Biopsy Sampling in Upper Gastrointestinal Endoscopy: A Survey from 10 Tertiary Referral Centres across Europe

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