Person: Saenz Fuenzalida, Roque Luis
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Saenz Fuenzalida
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Roque Luis
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Roque Luis Saenz Fuenzalida
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Publication The challenge of quantifying screening colonoscopy quality: Development and psychometric properties of the Colonoscopy Quality Score instrument(2022) Saenz Fuenzalida, Roque Luis; Riquelme, A.; Díaz, L.; García, X.; Fuentes, E; Arnold, J.; Caro, L.; Tchekmedyian, A.; Orellana, I.; Jover, R.Introduction and aims: Colonoscopy quality is measured by the degree in which the examination increases the likelihood of obtaining adequate results on health. Our aim was to develop an instrument for evaluating the quality of screening colonoscopies, taking into account the performance of endoscopists and endoscopy units. Materials and methods: Mixed methodology was employed. The first stage (qualitative) consisted of a Medline search, from which a group of experts developed the quality score items. The second stage (quantitative) utilized a modified Delphi technique to reach consensus (3 rounds). We evaluated the psychometric properties of the instrument (reliability and construct validity) in elective screening colonoscopies (in patients ≥ 50 years of age), performed within the January-April 2017 time frame. Results: A final instrument with 8 items was produced: (1) the Boston Bowel Preparation Scale score; (2) cecal intubation rate; (3) colonoscopy withdrawal time; (4) image documentation; (5) adenoma detection rate; (6) endoscopic surveillance planning; (7) perforation rate, and (8) continuous improvement programs. The instrument was evaluated in 323 colonoscopies performed by 31 endoscopists and found to be one-dimensional and reliable (Cronbach's alpha 0.76). Performance was compared between endoscopists (center 1) and an expert endoscopist from another center (center 2): Boston Bowel Preparation Scale score 8.3 vs. 7.36 (P < .001), cecal intubation rate 93.5 vs. 96%, colonoscopy withdrawal time 14.8 vs. 8.4 min (P < .001), and adenoma detection rate 34 vs. 52.2% (P < .001), respectively. Conclusion: The Colonoscopy Quality Score is a reliable and valid instrument for evaluating screening colonoscopy quality. Its results could be adapted to the usual endoscopic report to adjust monitorization frequency post-colonoscopy.Publication WGO Guideline - Endoscope Disinfection Update(2023) Speer, Tony; Alfa, Michelle; Jones, Dianne; Vickery, Karen; Griffiths, Helen; Saenz Fuenzalida, Roque LuisThe WGO Guideline “Endoscope Disinfection” is intended for use by health providers and professionals who are involved in the use, cleaning, and maintenance of endoscopes and aims to support national societies, official bodies and individual endoscopy departments in developing local standards and protocols for reprocessing endoscopes.Publication An efficient strategy for evaluating new non-invasive screening tests for colorectal cancer: the guiding principles(2023) Robert S Bresalier, Robert S.; Senore, Carlo; Young, Graeme P.; Allison, James; Benamouzig, Robert; Benton, Sally; Bossuyt, Patrick M.; Caro, Luis; Carvalho, Beatriz; Chiu, Han-Mo; Coupé, Veerle M. H.; Klaver, Willemijn de; Klerk, Clasine Maria de; Dekker, Evelien; Dolwani, Sunil; Fraser, Callum G.; Grady, William; Guittet, Lydia; Gupta, Samir; Halloran, Stephen P.; Haug, Ulrike; Hoff, Geir; Itzkowitz, Steven; Kortlever, Tim; Koulaouzidis, Anastasios; Ladabaum, Uri; Lauby-Secretan, Beatrice; Levin, Bernard; Levin, Theodore Robert; Meijer, Gerrit A.; Macrae, Finlay; Melson, Joshua; O'Morain, Colm; Parry, Susan; Rabeneck, Linda; Ransohoff, David F.; Saenz Fuenzalida, Roque Luis; Saito, Hiroshi; Sanduleanu-Dascalescu, SilviaObjective New screening tests for colorectal cancer (CRC) are rapidly emerging. Conducting trials with mortality reduction as the end point supporting their adoption is challenging. We re- examined the principles underlying evaluation of new non- invasive tests in view of technological developments and identification of new biomarkers. Design A formal consensus approach involving a multidisciplinary expert panel revised eight previously established principles. results Twelve newly stated principles emerged. Effectiveness of a new test can be evaluated by comparison with a proven comparator non- invasive test. The faecal immunochemical test is now considered the appropriate comparator, while colonoscopy remains the diagnostic standard. For a new test to be able to meet differing screening goals and regulatory requirements, f lexibility to adjust its positivity threshold is desirable. A rigorous and efficient four- phased approach is proposed, commencing with small studies assessing the test’s ability to discriminate between CRC and non- cancer states (phase I), followed by prospective estimation of accuracy across the continuum of neoplastic lesions in neoplasia- enriched populations (phase II). If these show promise, a provisional test positivity threshold is set before evaluation in typical screening populations. Phase III prospective studies determine single round intention- to- screen programme outcomes and confirm the test positivity threshold. Phase IV studies involve evaluation over repeated screening rounds with monitoring for missed lesions. Phases III and IV findings will provide the real- world data required to model test impact on CRC mortality and incidence. Conclusion New non- invasive tests can be efficiently evaluated by a rigorous phased comparative approach, generating data from unbiased populations that inform predictions of their health impact.