Observational Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 14, 2023; 29(2): 378-389
Published online Jan 14, 2023. doi: 10.3748/wjg.v29.i2.378
Knowledge and attitudes towards the use of histological assessments in ulcerative colitis by gastroenterologists vs pathologists
Aviv Pudipeddi, Caroline Fung, Britt Christensen, Robert V Bryant, Kavitha Subramaniam, John Chetwood, Sudarshan Paramsothy, Rupert W Leong
Aviv Pudipeddi, John Chetwood, Sudarshan Paramsothy, Rupert W Leong, Gastroenterology and Liver Services, Concord Repatriation General Hospital, Sydney 2139, Australia
Aviv Pudipeddi, Sudarshan Paramsothy, Rupert W Leong, Faculty of Medicine and Health, Concord Clinical School, University of Sydney, Sydney 2138, Australia
Caroline Fung, Department of Anatomical Pathology, Concord Repatriation General Hospital, Sydney 2139, Australia
Britt Christensen, Department of Gastroenterology, Royal Melbourne Hospital, Melbourne 3050, Australia
Britt Christensen, Department of Medicine, University of Melbourne, Melbourne 3052, Australia
Robert V Bryant, Department of Gastroenterology and Hepatology, The Queen Elizabeth Hospital, Adelaide 5011, Australia
Kavitha Subramaniam, Gastroenterology and Hepatology Unit, Canberra Hospital, Canberra 2605, Australia
Kavitha Subramaniam, Australian National University Medical School, Australian National University, Canberra 2601, Australia
Sudarshan Paramsothy, Rupert W Leong, Faculty of Medicine and Health Sciences, Macquarie University Hospital, Sydney 2109, Australia
Author contributions: Pudipeddi A and Leong RW designed the research study. Pudipeddi A, Chetwood J, Paramsothy S and Leong RW performed the research and collected data. Pudipeddi A, Chetwood J and Leong RW analysed the data. Pudipeddi A drafted the manuscript. Fung C, Christensen B, Bryant RV and Subramaniam K edited the manuscript; All authors have read and approve the final manuscript.
Institutional review board statement: The study was approved by the Sydney Local Health District Human Research Ethics Committee (HREC CH62/6/2021-055).
Informed consent statement: All study participants provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest.
Data sharing statement: The data underlying this article will be shared on reasonable request to the corresponding author.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Aviv Pudipeddi, FRACP, MBBS, Doctor, Gastroenterology and Liver Services, Concord Repatriation General Hospital, Level 1West ACE Unit, Concord Repatriation General Hospital, Hospital Road, Concord, Sydney 2139, Australia. avivpudipeddi@gmail.com
Received: September 11, 2022
Peer-review started: September 11, 2022
First decision: October 22, 2022
Revised: November 4, 2022
Accepted: December 23, 2022
Article in press: December 23, 2022
Published online: January 14, 2023
Processing time: 116 Days and 12.6 Hours
ARTICLE HIGHLIGHTS
Research background

The role of histology in ulcerative colitis has evolved over time. Histological activity despite endoscopic remission is associated with poorer clinical outcomes, and various histological scoring systems have been developed. However, the knowledge and attitudes towards the use of histology in the management of ulcerative colitis by gastroenterologists and pathologists is unknown.

Research motivation

Although there has been an increasing literature into the use of histology in ulcerative colitis, it is unknown whether this has translated into knowledge and use by gastroenterologists and pathologists in clinical practice.

Research objectives

The main objective was to evaluate the knowledge of histology guidelines and attitudes towards the use of histology in ulcerative colitis by gastroenterologists and pathologists.

Research methods

A prospective, cross-sectional survey of gastroenterologists and pathologists was conducted in Australia. The survey was formulated by using peer-reviewed guidelines.

Research results

Of 89 responders (77 gastroenterologists, 12 pathologists), there was almost complete acceptance that histological assessment should form part of ulcerative colitis evaluation (95% gastroenterologists, 92% pathologists). However, the majority of both groups lacked awareness of the Geboes score, Nancy index and Robarts histopathological index. Higher knowledge scores were predicted by public hospital attending gastroenterologists and involvement in an inflammatory bowel disease meeting.

Research conclusions

Histological remission is a recognised target for both gastroenterologists and pathologists. However knowledge of histological scoring systems was poor.

Research perspectives

Future research should involve the development of consensus guidelines in consultation with pathologists on the use of histology in ulcerative colitis management. This should include an agreement on a standardised scoring system to ensure homogenity in reporting across hospitals to permit comparability of biopsies.