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QM led clinical guidelines gain NICE accreditation

Clinical guidelines produced following research led by Queen Mary, University of London, will help drive improvements in the treatment of people with pre-cancerous and cancerous conditions of the oesophagus (gullet).

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Professor Janusz Jankowski
Professor Janusz Jankowski

The BArrett’s Dysplasia and Cancer (BAD CAT) taskforce has received accreditation from the National Institute of Clinical Evidence (NICE) Accreditation Advisory Committee for its evidence-based guidelines on the management of Barrett’s dysplasia and early adenocarcinoma (cancer) in the oesophagus.

In Barrett’s dysplasia, cells in the gullet become pre-cancerous and can then develop into oesophageal adenocarcinoma (cancer). Five-year survival following a diagnosis of adenocarcinoma is less than 15 per cent, and so it is important to detect and treat the conditions while they are still in their early stages.

The international BAD CAT taskforce, established in 2009, is co-ordinated by Dr Cathy Bennett and  Professor Janusz Jankowski, from the Blizard Institute at Barts and The London School of Medicine and Dentistry, part of Queen Mary. The BAD CAT group is the first producer of gastrointestinal (GI) guidance to be approved by NICE.

Professor Jankowski, who is the Sir James Black Professor of Gastrointestinal Biology and Trials, said: “There is inconsistency in the management of high grade dysplasia internationally and a real need for guidance in this topic area. We are extremely pleased to receive this NICE accreditation as it will help health care professionals recognise that they are accessing the best available support material and it gives us a real opportunity to have a positive impact on patient health.

“Oesophageal adenocarcinoma is an aggressive disease and therefore the new evidence contained in this review gives patients a real opportunity to benefit from recent advances in the understanding and management of the pre-malignant disease.”

The guidelines are based on a systematic review of 12,000 papers carried out by BAD CAT’s multi-national team of researchers. The review, published in the journal Gastroenterology earlier this year, found that good endoscopy equipment, more endoscopic surgery, and more tissue sampling are required to improve care for patients.

They used a new method of analysing the data, called the Delphi process, to reach agreement on the strength of the evidence contained within all the papers and to make recommendations for the management of patients with these conditions.

Dr Bennett, an Honorary Lecturer at the Blizard Institute, said: “The BAD CAT taskforce brought together gastroenterologists from around the world in many different specialties, giving us a wonderful expertise base to draw from.

“The techniques used in this review process – the largest in gastrointestinal medicine –could be adapted to all sorts of consensus research in other fields, not just medicine.”

NICE’s Accreditation Programme verifies the most robustly-produced guidance available to health and social care professionals. Accreditation, which lasts for five years, means that users will know that the guidance has been developed to a quality process, on the appropriate clinical guidelines.

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