Prospective controlled assessment of impact of feedback on gastroenterology trainees in outpatient practice.

Abstract:

BACKGROUND AND AIMS:Previous studies have demonstrated the value of systematic feedback in enhancing endoscopic procedure performance. It remains unknown whether feedback may play a role in modifying physician performance in outpatient practice. This study aimed to assess the impact of systematic feedback on duration of office visits of gastroenterology (GI) trainees in outpatient practice. METHODS:Patients attending a GI outpatient department in an academic medical center were prospectively followed over 4 months. The duration of office visits for consecutive patients seen by five GI fellows of similar experience level were recorded for 2 months (pre-feedback); confidential feedback was then provided to each fellow on a weekly basis for 2 months detailing their individual consultation times and the comparative, anonymous times of the other fellows (post-feedback). RESULTS:Over the course of the study, 1,647 outpatients were seen by five GI fellows. Pre-feedback consultation durations differed significantly with one fellow taking 2.5 times longer than their colleague. Following feedback, times shortened significantly for all fellows, with the greatest impact observed in those trainees taking longer at baseline. There were no significant differences in satisfaction levels among patients seen by each trainee. CONCLUSIONS:There was a wide disparity in the consultation times among GI fellows. Systematic feedback shortened times among all trainees and enhanced uniformity by having the greatest impact among those fellows taking longer at baseline. Routine provision of feedback may be valuable in enhancing uniformity of outpatient practice although clinicians should ensure that shortening consultation visits does not compromise quality of patient care. Future larger studies of feedback in this setting will be enhanced by incorporating objective measures of quality of care and patient satisfaction.

journal_name

Dig Dis Sci

authors

Harewood GC

doi

10.1007/s10620-011-1673-3

subject

Has Abstract

pub_date

2011-10-01 00:00:00

pages

2784-8

issue

10

eissn

0163-2116

issn

1573-2568

journal_volume

56

pub_type

杂志文章
  • Stevens-Johnson Syndrome and cholestatic hepatitis.

    abstract::Stevens-Johnson Syndrome (SJS) is a rare but severe dermatological condition that typically occurs after the ingestion of medications such as nonsteroidal drugs, antibiotics, and anticonvulsants. Extracutaneous manifestations of the syndrome can occur and may involve the conjunctiva, trachea, buccal mucosa, gastrointe...

    journal_title:Digestive diseases and sciences

    pub_type: 杂志文章,评审

    doi:10.1023/a:1012351231143

    authors: Morelli MS,O'Brien FX

    更新日期:2001-11-01 00:00:00

  • Hepatitis B vaccine response before and after transplantation in 55 extrahepatic biliary atresia children.

    abstract::Fifty-five children with cholestatic cirrhosis due to extrahepatic biliary atresia received a course of hepatitis B vaccine. Forty-seven received a plasma-derived vaccine and eight a recombinant vaccine. Antibody determination was evaluated before and after liver transplantation in 30 patients. Twenty-five additional ...

    journal_title:Digestive diseases and sciences

    pub_type: 杂志文章

    doi:10.1007/BF01296568

    authors: Sokal EM,Ulla L,Otte JB

    更新日期:1992-08-01 00:00:00

  • Transjugular Intrahepatic Porto-Systemic Shunt in Patients with Liver Cirrhosis and Model for End-Stage Liver Disease ≥15.

    abstract:BACKGROUND:It is not known whether transjugular intrahepatic porto-systemic shunt (TIPS) is safe in patients with advanced liver cirrhosis. The aim of our study was to evaluate the impact of TIPS on transplant-free survival in patients with liver cirrhosis and MELD score ≥15. METHODS:All adult patients who underwent T...

    journal_title:Digestive diseases and sciences

    pub_type: 杂志文章

    doi:10.1007/s10620-016-4185-3

    authors: Ascha M,Hanouneh M,S Ascha M,Zein NN,Sands M,Lopez R,Hanouneh IA

    更新日期:2017-02-01 00:00:00

  • Hospital Cirrhosis Volume and Readmission in Patients with Cirrhosis in California.

    abstract:BACKGROUND:Patients with cirrhosis are at high readmission risk. Using a large statewide database, we evaluated the effect of hospital cirrhosis-related patient volume on 30-day readmissions in patients with cirrhosis. METHODS:We conducted a retrospective study of the Healthcare Cost and Utilization Project State Inpa...

    journal_title:Digestive diseases and sciences

    pub_type: 杂志文章

    doi:10.1007/s10620-018-4964-0

    authors: Wei M,Ford J,Li Q,Jeong D,Kwong AJ,Nguyen MH,Chang MS

    更新日期:2018-09-01 00:00:00

  • Nonalcoholic fatty liver disease increases risk for gastroesophageal reflux symptoms.

    abstract:BACKGROUND:Nonalcoholic fatty liver disease (NAFLD) is now recognized as a leading cause of liver dysfunction. Gastroesophageal reflux disease (GERD) is a common disorder causing symptoms that often impair patients' quality of life. In recent years, the prevalence of both these diseases has increased, partially overlap...

    journal_title:Digestive diseases and sciences

    pub_type: 杂志文章

    doi:10.1007/s10620-014-3113-7

    authors: Catanzaro R,Calabrese F,Occhipinti S,Anzalone MG,Italia A,Milazzo M,Marotta F

    更新日期:2014-08-01 00:00:00

  • Omentum and basic fibroblast growth factor in healing of chronic gastric ulcerations in rats.

    abstract::Omentum was shown to exhibit angiogenic activity, but its role in healing of chronic gastric ulcers is unknown. This study was designed to compare the effects of omentum and basic fibroblast growth factor (bFGF), a potent angiogenic factor, on healing of chronic gastric ulcers in rats. Several series of rats with gast...

    journal_title:Digestive diseases and sciences

    pub_type: 杂志文章

    doi:10.1007/BF02087559

    authors: Konturek SJ,Brzozowski T,Majka I,Pawlik W,Stachura J

    更新日期:1994-05-01 00:00:00

  • Gastroesophageal reflux disease: relationship between clinical and histological features. GOSPE. Gruppo Operativo per lo Studio delle Precancerosi dell'Esofago.

    abstract::Our purpose was to evaluate the relationship between the clinical and histological features in a cohort of patients who had gastroesophageal reflux-related lesions diagnosed after upper digestive endoscopy. In all, 589 patients scheduled for elective endoscopy in a multicentric prospective study were evaluated. Multip...

    journal_title:Digestive diseases and sciences

    pub_type: 杂志文章,多中心研究

    doi:10.1023/a:1026666417658

    authors: Aste H,Bonelli L,Ferraris R,Conio M,Lapertosa G

    更新日期:1999-12-01 00:00:00

  • Endoscopic evaluation of the effect of sucralfate therapy and other clinical parameters on the recurrence rate of gastric ulcers.

    abstract::A randomized controlled clinical study was conducted to determine (a) whether basic aluminum sucrose sulfate (sucralfate) is effective in preventing or reducing gastric ulcer recurrence, and (b) the clinical parameters contributing to ulcer recurrence after endoscopically proved healing has been effected. A total of 1...

    journal_title:Digestive diseases and sciences

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1007/BF01312725

    authors: Miyake T,Ariyoshi J,Suzaki T,Oishi M,Sakai M,Ueda S

    更新日期:1980-01-01 00:00:00

  • Intravenous versus high-dose oral proton pump inhibitor therapy after endoscopic hemostasis of high-risk lesions in patients with acute nonvariceal upper gastrointestinal bleeding.

    abstract::Intravenous proton pump inhibitors (IV PPIs) decrease rebleeding following endoscopic hemostasis of bleeding peptic ulcers. Oral PPIs may be equally efficacious and may significantly reduce health care costs. This study aimed to compare outcomes in patients receiving oral versus IV PPI therapy following endoscopic hem...

    journal_title:Digestive diseases and sciences

    pub_type: 杂志文章

    doi:10.1007/s10620-006-9684-1

    authors: Murthy S,Keyvani L,Leeson S,Targownik LE

    更新日期:2007-07-01 00:00:00

  • Hemodynamic effects of rapid injection into the canine superior mesenteric artery.

    abstract::We explored the hemodynamic effects of rapid injection of 0.9% saline and arterial blood into the canine superior mesenteric artery in anesthetized animals. Mesenteric artery blood flow and pressure were measured in the vessel distal to the site of injection. Injection rates were at or below the rate of blood flow in ...

    journal_title:Digestive diseases and sciences

    pub_type: 杂志文章

    doi:10.1007/BF01309495

    authors: Jacobson ED,Eldon C,Fondacaro JD

    更新日期:1981-10-01 00:00:00

  • Effectiveness of concomitant enteral nutrition therapy and infliximab for maintenance treatment of Crohn's disease in adults.

    abstract:BACKGROUND:One of the problems associated with infliximab (IFX) treatment for Crohn's disease (CD) is loss of response during maintenance therapy. AIMS:The aim of this multicenter, retrospective, cohort study was to determine whether enteral nutrition (EN) added to the IFX therapy regimen is effective for maintaining ...

    journal_title:Digestive diseases and sciences

    pub_type: 杂志文章

    doi:10.1007/s10620-012-2374-2

    authors: Hirai F,Ishihara H,Yada S,Esaki M,Ohwan T,Nozaki R,Ashizuka S,Inatsu H,Ohi H,Aoyagi K,Mizuta Y,Matsumoto T,Matsui T

    更新日期:2013-05-01 00:00:00

  • Halofuginone, a specific inhibitor of collagen type 1 synthesis, ameliorates oxidant colonic damage in rats with experimental colitis.

    abstract::To evaluate the effect of halofuginone on trinitrobenzene sulfonic acid (TNBS)-induced colonic injury, rats were given halofuginone (40 microg/kg, intraperitoneally) or saline 1 h before the induction of colitis, and the injections were continued twice daily for 3 days until they were decapitated. High macroscopic and...

    journal_title:Digestive diseases and sciences

    pub_type: 杂志文章

    doi:10.1007/s10620-009-0798-0

    authors: Karakoyun B,Yüksel M,Ercan F,Salva E,Işik I,Yeğen BC

    更新日期:2010-03-01 00:00:00

  • Prooxidant properties of 5-aminosalicylic acid. Possible mechanism for its adverse side effects.

    abstract::There is a growing body of experimental and clinical evidence to suggest that oral or rectal administration of 5-ASA or 5-ASA conjugates is associated with significant adverse side effects including pancreatitis, hepatitis, and renal toxicity. The objective of this study was to assess the ability of 5-ASA to interact ...

    journal_title:Digestive diseases and sciences

    pub_type: 杂志文章

    doi:10.1007/BF01296008

    authors: Grisham MB,Ware K,Marshall S,Yamada T,Sandhu IS

    更新日期:1992-09-01 00:00:00

  • Jejunal perforation possibly induced by slow-release potassium in a patient with Crohn's disease.

    abstract::A case of small bowel ulceration and perforation possibly due to therapy with Klotrix in a patient with Crohn's disease is presented. Following emergent surgery with creation of a diverting loop jejunostomy, subsequent reestablishment of intestinal continuity was carried out with excellent clinical results. Gastrointe...

    journal_title:Digestive diseases and sciences

    pub_type: 杂志文章

    doi:10.1007/BF01299819

    authors: Brower RA

    更新日期:1986-12-01 00:00:00

  • Increased Prevalence of Obesity and Metabolic Syndrome in Patients with Alcoholic Fatty Liver Disease.

    abstract:BACKGROUND AND AIMS:Obesity and diabetes are risk factors for advanced alcoholic liver disease, and both are components of the metabolic syndrome. We aimed to assess the prevalence of metabolic syndrome and its components in a contemporary US cohort of adults with alcoholic liver disease and compare it to a historic co...

    journal_title:Digestive diseases and sciences

    pub_type: 杂志文章

    doi:10.1007/s10620-020-06056-1

    authors: Singh A,Amin H,Garg R,Gupta M,Lopez R,Alkhouri N,MCCullough A

    更新日期:2020-11-01 00:00:00

  • Efficacy of 5-aminosalicylic acid enemas versus hydrocortisone enemas in ulcerative colitis.

    abstract::A controlled trial has been carried out in order to compare the efficacy of enemas containing a high dosage of 5-ASA (4 g) versus enemas containing hydrocortisone 100 mg. The trial was conducted on 86 patients, 44 of whom received 5-ASA and 42 received hydrocortisone. The results were favorable in terms of clinical, s...

    journal_title:Digestive diseases and sciences

    pub_type: 临床试验,杂志文章

    doi:10.1007/BF01312467

    authors: Campieri M,Gionchetti P,Belluzzi A,Brignola C,Migaldi M,Tabanelli GM,Bazzocchi G,Miglioli M,Barbara L

    更新日期:1987-12-01 00:00:00

  • Octreotide uptake in intracranial metastasis of pancreatic ductal adenocarcinoma origin in a patient with a prolonged clinical course.

    abstract::We describe a case with prolonged survival of 2 years in a female patient with pancreatic ductal adenocarcinoma who, at diagnosis, already had liver spread and eventually succumbed to brain metastases which scanned positive with [(111)In-DTPA] octreotide scintiscan (OctreoScan). Subsequently, the patient underwent a c...

    journal_title:Digestive diseases and sciences

    pub_type: 杂志文章

    doi:10.1007/s10620-008-0531-4

    authors: Marepaily R,Micheals D,Sloan A,Hatfield J,Adsay V,Joyrich R,Ullah N,Tobi M

    更新日期:2009-01-01 00:00:00

  • Liver histology changes in nonalcoholic steatohepatitis after one year of treatment with probucol.

    abstract:BACKGROUND:Probucol, a lipid-lowering agent with antioxidant effects, is effective in normalizing liver enzymes in patients with nonalcoholic steatohepatitis (NASH). We studied changes in the liver histology of patients with NASH after use of probucol for one year. METHODS:Ten patients with biopsy-proven NASH were inc...

    journal_title:Digestive diseases and sciences

    pub_type: 临床试验,杂志文章

    doi:10.1007/s10620-007-0109-6

    authors: Merat S,Aduli M,Kazemi R,Sotoudeh M,Sedighi N,Sohrabi M,Malekzadeh R

    更新日期:2008-08-01 00:00:00

  • Hyperplastic polyps of the gastric antrum in patients with gastrointestinal blood loss.

    abstract::The significance of hyperplastic polyps of the gastric antrum in anemic patients with suspected gastrointestinal bleeding has not been determined. The aim of this study is to evaluate the prevalence and prognosis of such polyps in this patient group. Clinical records of patients referred to our endoscopy lab from Nove...

    journal_title:Digestive diseases and sciences

    pub_type: 杂志文章

    doi:10.1007/s10620-006-9182-5

    authors: Al-Haddad M,Ward EM,Bouras EP,Raimondo M

    更新日期:2007-01-01 00:00:00

  • Clinical Features and Colonic Motor Disturbances in Chronic Megacolon in Adults.

    abstract:BACKGROUND:Chronic megacolon is a rare disease of the colonic motor function characterized by a permanent increase in colonic diameter. METHODS:We reviewed electronic medical records of all patients diagnosed with chronic megacolon from 1999 to 2014 at Mayo Clinic. Our aim was to summarize clinical and motility featur...

    journal_title:Digestive diseases and sciences

    pub_type: 杂志文章

    doi:10.1007/s10620-015-3645-5

    authors: O'Dwyer RH,Acosta A,Camilleri M,Burton D,Busciglio I,Bharucha AE

    更新日期:2015-08-01 00:00:00

  • Mucosal glucosamine synthetase activity in inflammatory bowel disease.

    abstract::Abnormalities in colonic glycoprotein synthesis have been implicated in the pathogenesis of ulcerative colitis and Crohn's disease. Glucosamine synthetase is the rate-limiting step in the biosynthesis of gastrointestinal glycoprotein and has been measured in control subjects (N = 23) and patients with ulcerative colit...

    journal_title:Digestive diseases and sciences

    pub_type: 杂志文章

    doi:10.1007/BF02088339

    authors: Winslet MC,Poxon V,Allan A,Keighley MR

    更新日期:1994-03-01 00:00:00

  • Effects of fluoride on structure and function of canine gastric mucosa.

    abstract::These studies were done to determine the effects of fluoride (F) on the structure and function of the canine gastric mucosa and the possible protective effects of 16,16-dimethyl-prostaglandin E2 (dmPGE2). A portion of the stomach with its vascular supply intact was mounted in a two-compartment chamber, one side of whi...

    journal_title:Digestive diseases and sciences

    pub_type: 杂志文章

    doi:10.1023/a:1018895207333

    authors: Whitford GM,Pashley DH,Garman RH

    更新日期:1997-10-01 00:00:00

  • Ileocecal ulcer in central China: case series.

    abstract::Diseases of the ileocecal junction are mostly ulcerative. The aim of this study was to investigate the value of colonoscopy on the diagnosis of the causes of ileocecal ulcer. Clinical manifestations, diagnosis, and endoscopic and histopathologic features of 52 hospitalized cases of ileocecal ulcer were retrospectively...

    journal_title:Digestive diseases and sciences

    pub_type: 杂志文章

    doi:10.1007/s10620-006-9548-8

    authors: Cai J,Li F,Zhou W,Luo HS

    更新日期:2007-11-01 00:00:00

  • Hydroxysteroid 17-Beta Dehydrogenase 6 Is a Prognostic Biomarker and Correlates with Immune Infiltrates in Hepatocellular Carcinoma.

    abstract:BACKGROUND:Hepatocellular carcinoma (HCC) is a common malignancy worldwide with poor outcomes. Therefore, it is important to identify a valuable prognostic biomarker for HCC. The present study aimed to identify novel prognostic biomarkers for HCC and evaluate the potential role of hub genes in HCC. METHODS:Weighted ge...

    journal_title:Digestive diseases and sciences

    pub_type: 杂志文章

    doi:10.1007/s10620-021-06832-7

    authors: Wu M,Jiang L

    更新日期:2021-01-26 00:00:00

  • Magnifying chromoendoscopic findings of early gastric cancer and gastric adenoma.

    abstract:PURPOSE:In the field of colorectal cancer and adenoma, Kudo's classification of pit pattern with magnifying chromocolonoscopy using crystal violet (CV) staining is now accepted. Magnifying endoscopy using narrow band imaging has been used for the diagnosis of gastric carcinoma; the characteristic findings of microvascu...

    journal_title:Digestive diseases and sciences

    pub_type: 杂志文章

    doi:10.1007/s10620-011-1638-6

    authors: Ohnita K,Isomoto H,Shikuwa S,Yamaguchi N,Nakayama T,Nishiyama H,Okamoto K,Fukuda E,Takeshima F,Hayashi T,Kohno S,Nakao K

    更新日期:2011-09-01 00:00:00

  • Effects of ursodeoxycholate and other bile salts on levels of rat intestinal alkaline sphingomyelinase: a potential implication in tumorigenesis.

    abstract::Previous studies showed that bile salts had a promoting effect on colon cancer development and this effect was inhibited by ursodeoxycholate (UDC). We recently found that both human colorectal adenomas and carcinomas were associated with a specific decrease in alkaline sphingomyelinase activity. In this work, we compa...

    journal_title:Digestive diseases and sciences

    pub_type: 杂志文章

    doi:10.1023/a:1018807600683

    authors: Duan RD,Cheng Y,Tauschel HD,Nilsson A

    更新日期:1998-01-01 00:00:00

  • Vagal control of transpyloric flow and pyloric resistance.

    abstract::Vagal control of pyloric resistance was evaluated in anesthetised pigs by recording gastropyloroduodenal motility and transpyloric flow during emptying of a liquid nonnutrient meal. Vagotomy did not modify pyloric resistance or the characteristics of the flow pulses. Electrical stimulation of the distal stumps of cerv...

    journal_title:Digestive diseases and sciences

    pub_type: 杂志文章

    doi:10.1007/BF02300364

    authors: Malbert CH,Mathis C,Laplace JP

    更新日期:1994-12-01 00:00:00

  • Gastric mucosal blood flow regulation in response to different stimuli.

    abstract::We compared changes in gastric mucosal blood flow (GMBF) and left gastric artery blood flow (LGABF) in response to pharmacological, physiological, and pathological stimuli. GMBF and LGABF were measured by the hydrogen gas clearance and perivascular ultrasonic transit time techniques, respectively, under baseline condi...

    journal_title:Digestive diseases and sciences

    pub_type: 杂志文章

    doi:10.1023/a:1018807009266

    authors: Méndez A,Casadevall M,Wachter CH,Elizalde JI,Del Rivero M,Heinemann A,Holzer P,Quintero E,Piqué JM

    更新日期:1997-09-01 00:00:00

  • Nucleotide sequence analysis of the precore region in patients with spontaneous reactivation of chronic hepatitis B.

    abstract::The role of HBV precore mutations in the spontaneous reactivation of chronic hepatitis B (CHB) is currently unknown. We studied 10 patients with CHB; five were HBeAg+ (group I) and five were anti-HBe+ (group II). All 10 had spontaneous reactivation of CHB as defined by the appearance of clinical symptoms along with an...

    journal_title:Digestive diseases and sciences

    pub_type: 杂志文章

    doi:10.1007/BF02088138

    authors: Laskus T,Rakela J,Tong MJ,Persing DH

    更新日期:1994-09-01 00:00:00

  • Mechanisms of Probiotic VSL#3 in a Rat Model of Visceral Hypersensitivity Involves the Mast Cell-PAR2-TRPV1 Pathway.

    abstract:BACKGROUND:Mast cells (MCs), PAR2 and TRPV1, play a key role in the regulation of visceral pain. Several studies have found that probiotics regulate visceral sensitivity. AIMS:The purpose of the current study was to explore the role of MC-PAR2-TRPV1 in VH and the mechanism of VSL#3 in a rat model of VH. METHODS:A tot...

    journal_title:Digestive diseases and sciences

    pub_type: 杂志文章

    doi:10.1007/s10620-018-5416-6

    authors: Li YJ,Dai C,Jiang M

    更新日期:2019-05-01 00:00:00