Adrian J. Stanley
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View article: Empowering Healthcare Leadership Through Facilitators of Evidence-Based Management: A Narrative Review and Proposed Conceptual Framework
Empowering Healthcare Leadership Through Facilitators of Evidence-Based Management: A Narrative Review and Proposed Conceptual Framework Open
Decision-making in healthcare leadership often relies on subjective experiences rather than structured, evidence-based approaches, leading to inefficiency, missed opportunities for improvement and ineffective control over rising healthcare…
View article: Gaps in acute upper GI bleed (AUGIB) endoscopy training: a UK trainees and trainers’ survey
Gaps in acute upper GI bleed (AUGIB) endoscopy training: a UK trainees and trainers’ survey Open
Introduction Trainees report inadequate exposure and training barriers in acute upper gastrointestinal bleed (AUGIB) endoscopic management. This UK-wide survey evaluated the experiences of trainees and trainers in AUGIB endoscopy training.…
View article: Beta-blockers or Placebo for Primary Prophylaxis (BOPPP) of oesophageal varices: study protocol for a randomised controlled trial
Beta-blockers or Placebo for Primary Prophylaxis (BOPPP) of oesophageal varices: study protocol for a randomised controlled trial Open
Background Liver disease is within the top five causes of premature death in adults. Deaths caused by complications of cirrhosis continue to rise, whilst deaths related to other non-liver disease areas are declining. Portal hypertension is…
View article: Study protocol for a Randomised controlled trial of EArly transjugular intrahepatiC porTosystemic stent–shunt in Acute Variceal Bleeding (REACT-AVB trial)
Study protocol for a Randomised controlled trial of EArly transjugular intrahepatiC porTosystemic stent–shunt in Acute Variceal Bleeding (REACT-AVB trial) Open
Introduction In liver cirrhosis, acute variceal bleeding (AVB) is associated with a 1-year mortality rate of up to 40%. Data on early or pre-emptive transjugular intrahepatic portosystemic stent–shunt (TIPSS) in AVB is inconclusive and may…
View article: Machine learning in the assessment and management of acute gastrointestinal bleeding
Machine learning in the assessment and management of acute gastrointestinal bleeding Open
### Key messages > Integration of machine learning has the potential to transform the management of acute gastrointestinal bleeding, but a transparent and collaborative approach will be key, argue Gaurav Nigam and colleagues Acute gastroin…
View article: CURRENT PHARMACOLOGICAL MANAGEMENT IN UPPER GASTROINTESTINAL BLEEDING
CURRENT PHARMACOLOGICAL MANAGEMENT IN UPPER GASTROINTESTINAL BLEEDING Open
Upper gastrointestinal bleeding is a common reason for presentation to the hospital. Appropriate resuscitation followed by endoscopic assessment and endotherapy for high-risk lesions (active bleeding or non-bleeding with visible vessels) f…
View article: Impact of the COVID-19 pandemic on patients with hepatocellular carcinoma in the West of Scotland: a cohort study
Impact of the COVID-19 pandemic on patients with hepatocellular carcinoma in the West of Scotland: a cohort study Open
Objective The COVID-19 pandemic had an undoubted impact on the provision of elective and emergency cancer care, including the diagnosis and management of patients with hepatocellular carcinoma (HCC). Our aim was to determine the effects of…
View article: A Review of Risk Scores within Upper Gastrointestinal Bleeding
A Review of Risk Scores within Upper Gastrointestinal Bleeding Open
Upper gastrointestinal bleeding is a common medical emergency. Thorough initial assessment and appropriate resuscitation are essential to stabilise the patient. Risk scores provide an important tool to discriminate between lower- and highe…
View article: Guidance document: risk assessment of patients with cirrhosis prior to elective non-hepatic surgery
Guidance document: risk assessment of patients with cirrhosis prior to elective non-hepatic surgery Open
As a result of the increasing incidence of cirrhosis in the UK, more patients with chronic liver disease are being considered for elective non-hepatic surgery. A historical reluctance to offer surgery to such patients stems from general pe…
View article: Letter: improve survival in variceal bleeding in cirrhosis—place <scp>pTIPS</scp> as early as possible after index bleed. Authorsʼ reply
Letter: improve survival in variceal bleeding in cirrhosis—place <span>pTIPS</span> as early as possible after index bleed. Authorsʼ reply Open
LINKED CONTENT This article is linked to Dunne et al papers. To view these articles, visit https://doi.org/10.1111/apt.17252 and https://doi.org/10.1111/apt.17322
View article: Update on the management of upper gastrointestinal bleeding
Update on the management of upper gastrointestinal bleeding Open
Upper gastrointestinal bleeding is a common emergency presentation requiring prompt resuscitation and management. Peptic ulcers are the most common cause of the condition. Thorough initial management with a structured approach is vital wit…
View article: Rebleeding in peptic ulcer bleeding – a nationwide cohort study of 19,537 patients
Rebleeding in peptic ulcer bleeding – a nationwide cohort study of 19,537 patients Open
Rebleeding is a frequent complication of peptic ulcer bleeding (PUB). The associated prognosis remains rather unclear because previous studies generally also included non-ulcer lesions. We aimed to identify predictors for rebleeding; clari…
View article: Editorial: the impact of red blood cell transfusion on inpatient mortality in upper gastrointestinal bleeding
Editorial: the impact of red blood cell transfusion on inpatient mortality in upper gastrointestinal bleeding Open
LINKED CONTENT This article is linked to Radadiya et al papers. To view these articles, visit https://doi.org/10.1111/apt.16965 and https://doi.org/10.1111/apt.17053
View article: Letter: non‐selective beta‐blockers in cirrhosis—effect beyond portal hypertension. Authors' reply
Letter: non‐selective beta‐blockers in cirrhosis—effect beyond portal hypertension. Authors' reply Open
LINKED CONTENT This article is linked to Dunne et al papers. To view these articles, visit https://doi.org/10.1111/apt.16901 and https://doi.org/10.1111/apt.16941
View article: International multicenter study comparing demographics, therapy and outcomes in bleeding from Mallory Weiss tears and peptic ulcers
International multicenter study comparing demographics, therapy and outcomes in bleeding from Mallory Weiss tears and peptic ulcers Open
Background and study aims Mallory Weiss tears (MWTs) are relatively uncommon causes of upper gastrointestinal bleeding (UGIB), and patients are generally considered at low risk of poor outcome, although data are limited. There is uncertain…
View article: MURAL: An Unsupervised Random Forest-Based Embedding for Electronic Health Record Data
MURAL: An Unsupervised Random Forest-Based Embedding for Electronic Health Record Data Open
A major challenge in embedding or visualizing clinical patient data is the heterogeneity of variable types including continuous lab values, categorical diagnostic codes, as well as missing or incomplete data. In particular, in EHR data, so…
View article: PWE-46 Impact of the COVID-19 pandemic on patients with Hepatocellular Carcinoma in the West of Scotland
PWE-46 Impact of the COVID-19 pandemic on patients with Hepatocellular Carcinoma in the West of Scotland Open
Introduction The COVID-19 pandemic has focused medical resources on acute and critical care, with an impact on patients with chronic illness. Worldwide, HCC surveillance, imaging and clinic follow-up may have been impacted, which is likely…
View article: HTH-5 Could machine learning (ML) improve indices for predicting outcome of AUGIB?
HTH-5 Could machine learning (ML) improve indices for predicting outcome of AUGIB? Open
Introduction Risk stratification scores for acute upper gastrointestinal bleeding (AUGIB) have limitations. ML models using multiple variables have the potential to improve predictive value. Methods Patients undergoing at least one endosco…
View article: HFR-5 Increasing the low-risk threshold for patients with upper gastrointestinal bleeding during the COVID-19 pandemic
HFR-5 Increasing the low-risk threshold for patients with upper gastrointestinal bleeding during the COVID-19 pandemic Open
Introduction In light of the COVID-19 pandemic, speciality groups have recommended down-scaling endoscopy (OGD) provision to true emergencies only. Following review of a large UK study on Upper Gastrointestinal Bleeding (UGIB), we extended…
View article: OWE-5 Carvedilol vs. endoscopic band ligation for variceal bleeding secondary prophylaxis; long-term RCT follow-up
OWE-5 Carvedilol vs. endoscopic band ligation for variceal bleeding secondary prophylaxis; long-term RCT follow-up Open
Introduction Carvedilol reduces rates of variceal bleeding and rebleeding by lowering portal pressure. However, an associated pleotropic survival benefit has been proposed. We aim to investigate further by undertaking long-term follow-up o…
View article: OWE-3 Timing of pre-emptive TIPS does not alter patient outcome, a UK multicentre study
OWE-3 Timing of pre-emptive TIPS does not alter patient outcome, a UK multicentre study Open
Introduction International guidelines suggest consideration of pre-emptive transjugular intrahepatic portosystemic shunt (pTIPS) within 72h of endoscopic haemostasis following acute oesophageal variceal bleeding (OVB) in 'high-risk' patien…
View article: Increasing the low-risk threshold for patients with upper gastrointestinal bleeding during the COVID-19 pandemic: a prospective, multicentre feasibility study
Increasing the low-risk threshold for patients with upper gastrointestinal bleeding during the COVID-19 pandemic: a prospective, multicentre feasibility study Open
Objective During the COVID-19 pandemic, we extended the low-risk threshold for patients not requiring inpatient endoscopy for upper gastrointestinal bleeding (UGIB) from Glasgow Blatchford Score (GBS) 0–1 to GBS 0–3. We studied the safety …
View article: Editorial: acute gastrointestinal bleeding – proposed new study outcomes
Editorial: acute gastrointestinal bleeding – proposed new study outcomes Open
LINKED CONTENT This article is linked to Jensen et al and Jensen & Barkun papers. To view these articles, https://doi.org/10.1111/apt.16483 and https://doi.org/10.1111/apt.16545
View article: The Value of Quantitative Faecal Immunochemical Testing as a Prioritisation Tool for the Endoscopic Investigation of Patients With Iron Deficiency
The Value of Quantitative Faecal Immunochemical Testing as a Prioritisation Tool for the Endoscopic Investigation of Patients With Iron Deficiency Open
Difficulty in providing endoscopy for patients with iron deficiency anaemia (IDA) during the COVID-19 pandemic has highlighted the requirement for a prioritisation tool. We aimed to test the validity of qFIT as a prioritisation tool in pat…
View article: Effect of Hepatocellular Carcinoma Surveillance Programmes on Overall Survival in a Mixed Cirrhotic UK Population: A Prospective, Longitudinal Cohort Study
Effect of Hepatocellular Carcinoma Surveillance Programmes on Overall Survival in a Mixed Cirrhotic UK Population: A Prospective, Longitudinal Cohort Study Open
Introduction: Surveillance for hepatocellular carcinoma (HCC) is recommended by national and international guidelines. However, there are no trial data on whether surveillance improves clinical outcomes in a UK cirrhosis population of mixe…
View article: Letter: enhancing training opportunities for upper GI bleeding in Sheffield ‐ a UK transferable model? Authors' reply
Letter: enhancing training opportunities for upper GI bleeding in Sheffield ‐ a UK transferable model? Authors' reply Open
LINKED CONTENT This article is linked to Chaudhary et al and Adu–Tei et al papers. To view these articles, visit https://doi.org/10.1111/apt.16170 and https://doi.org/10.1111/apt.16354
View article: Endoscopic diagnosis and management of nonvariceal upper gastrointestinal hemorrhage (NVUGIH): European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2021
Endoscopic diagnosis and management of nonvariceal upper gastrointestinal hemorrhage (NVUGIH): European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2021 Open
MAIN RECOMMENDATIONS 1 ESGE recommends in patients with acute upper gastrointestinal hemorrhage (UGIH) the use of the Glasgow–Blatchford Score (GBS) for pre-endoscopy risk stratification. Patients with GBS ≤ 1 are at very low risk of reble…
View article: Twitter debate: controversies in management of upper gastrointestinal bleeding
Twitter debate: controversies in management of upper gastrointestinal bleeding Open
The latest in the series of ‘Controversies in…’ Twitter debates for Frontline Gastroenterology was led by AJS (@AdrianStanleyGI) in a discussion on the topic of acute upper gastrointestinal bleeding (UGIB). This remains a medical emergency…