scholarly journals S1141 Gaps in the Patient Journey Through the Diagnosis and Management of Primary Biliary Cholangitis

2021 ◽  
Vol 116 (1) ◽  
pp. S535-S535
Author(s):  
Kimberly Brown ◽  
Apurva Modi ◽  
Kris Kowdley
2016 ◽  
Vol 7 (3) ◽  
pp. ar.2016.7.0165 ◽  
Author(s):  
Aleena Banerji ◽  
Murat Baş ◽  
Jonathan A. Bernstein ◽  
Isabelle Boccon-Gibod ◽  
Maria Bova ◽  
...  

Background Published literature documents the substantial burden of hereditary angioedema (HAE) with C1 inhibitor deficiency on the quality of life and work productivity of patients. However, despite advances in the field and the availability of guidelines to advise health care providers (HCP) on the diagnosis and management of HAE, there are still many challenges to overcome. For example, delayed diagnosis and misdiagnosis are common, and treatment practices vary worldwide. Objective An international expert panel was convened to consider opportunities for improvements that would benefit patients with HAE. Methods Based on professional and personal experiences, the experts developed schematics to describe the journey of patients through the following stages: (1) onset of symptoms and initial evaluation; (2) referral/diagnosis; and (3) management of HAE. More importantly, the panel identified key areas in which it was possible to optimize the support provided to patients and HCPs along this journey. Results Overall, this approach highlighted the need for wider dissemination of algorithms and scientific data to more effectively educate HCPs from multiple disciplines and the need for more research to inform appropriate treatment decisions. Furthermore, HAE awareness campaigns, accurate online information, and referral to patient advocacy groups were all considered helpful approaches to support patients. Conclusion More detailed and widespread information on the diagnosis and management of HAE is needed and may lead to advancements in care throughout the journey of the patient with HAE.


2019 ◽  
Vol 114 (1) ◽  
pp. 48-63 ◽  
Author(s):  
Zobair M. Younossi ◽  
David Bernstein ◽  
Mitchell L. Shiffman ◽  
Paul Kwo ◽  
W. Ray Kim ◽  
...  

2018 ◽  
Vol 50 (1) ◽  
pp. 42-43
Author(s):  
A. Floreani ◽  
B. Marini ◽  
S. Provisione ◽  
C. Bassanelli ◽  
E. De Santis ◽  
...  

2019 ◽  
Vol 2 (3) ◽  
pp. e5-e11
Author(s):  
William S Taylor

Background and Objective Upper tract urothelial carcinoma (UTUC) is rare in comparison to urothelial carcinoma of the bladder or renal cell carcinoma. UTUC may present with loin pain, haematuria or alternatively can be identified as an incidental finding on imaging. There are often delays to diagnosis as haematuria clinics are efficient for bladder and renal cancer but less effective for UTUC. The diagnosis and treatment of UTUC is more challenging, as it often requires two operations and multiple MDT discussions. Diagnosis must be certain to avoid unnecessary radical surgery.   We found that our patients were experiencing significant delays to definitive surgery. Our patients currently follow the pathway for bladder and renal cancer, as there is no UTUC pathway at or trust or published in the literature.  We audited our diagnostic pathway to see how we could tailor the pathway to be more effective for patients with UTUC. This will ensure that more patients will meet the NHS 62-day targets.   Materials and Methods A retrospective review of patients management pathway from December 2008 to December 2018. Patients were identified by the pathological code for UTUC.   Results A total of 62 patients underwent nephroureterectomy during a 10-year period. 48 patients were analysed. The median waiting time for haematuria clinic from referral was 21days, a further 73 days to ureterorenoscopy and biopsy, and then 14 days to definitive nephroureterectomy. Only one patient met the NHS 62-day treatment target.   Our waiting times are comparable with other published international series. We have implemented a new UTUC pathway to streamline the diagnosis and management of UTUC. Some patients with UTUC will still have inevitable delays as diagnosis can be very challenging but this new pathway should improve the patient journey and reduce the waiting times significantly.


2017 ◽  
Vol 67 (1) ◽  
pp. 145-172 ◽  
Author(s):  
Gideon M. Hirschfield ◽  
Ulrich Beuers ◽  
Christophe Corpechot ◽  
Pietro Invernizzi ◽  
David Jones ◽  
...  

JAMA ◽  
1966 ◽  
Vol 195 (3) ◽  
pp. 167-172 ◽  
Author(s):  
T. E. Van Metre

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