Abstract
Background
Ulcerative colitis (UC) is a chronic inflammatory bowel disease of multifactorial
etiology that primarily affects the colonic mucosa. The disease progresses over time,
and clinical management guidelines should reflect its dynamic nature. There is limited
evidence supporting UC management in specific clinical situations, thus precluding
an evidence-based approach.
Aim
To use a formal consensus method – the nominal group technique (NGT) – to develop
a clinical practice expert opinion to outline simple algorithms and practices, optimize
UC management, and assist clinicians in making treatment decisions.
Methods
The consensus was developed by an expert panel of 37 gastroenterologists from various
professional organizations with experience in UC management using the qualitative
and iterative NGT, incorporating deliberations based on the European Crohn's and Colitis
Organisation recommendations, recent reviews of scientific literature, and pertinent
discussion topics developed by a steering committee. Examples of clinical cases for
which there are limited evidence-based data from clinical trials were used. Two working
groups proposed and voted on treatment algorithms that were then discussed and voted
for by the nominal group as a whole, in order to reach a consensus.
Results
A clinical practice guideline covering management of the following clinical situations
was developed: (i) moderate and severe UC; (ii) acute severe UC; (iii) pouchitis;
(iv) refractory proctitis, in the form of treatment algorithms.
Conclusions
Given the limited available evidence-based data, a formal consensus methodology was
used to develop simple treatment guidelines for UC management in different clinical
situations that is now accessible via an online application.
Keywords
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Article info
Publication history
Published online: May 03, 2016
Accepted:
March 24,
2016
Received:
January 7,
2016
Identification
Copyright
© 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
