News from AGA

AGA has published new expert recommendations in Gastroenterology: AGA Institute Rapid Review of the GI and Liver Manifestations of COVID-19, Meta-Analysis of International Data, and Recommendations for the Consultative Management of Patients with COVID-19.

Key guidance for gastroenterologists:

• GI symptoms are not as common in COVID-19 as previously estimated: The overall prevalence was 7.7% (95% CI 7.4 to 8.6%) for diarrhea, 7.8% (95% CI: 7.1 to 8.5%) for nausea/vomiting, and 3.6% (95% CI 3.0 to 4.3%) for abdominal pain. Notably, in outpatients, the pooled prevalence of diarrhea is lower (4.0%).
• However, COVID-19 can present atypically, with GI symptoms: COVID-19 can present with diarrhea as an initial symptom, with a pooled prevalence of 7.9% across 35 studies, encompassing 9,717 patients. Most often, diarrhea is accompanied by other upper respiratory infection symptoms. However, in some cases, diarrhea can precede other symptoms by a few days, and COVID-19 may present as isolated GI symptoms prior to the development of upper respiratory infection symptoms.
• Monitor patients with new diarrhea, nausea, or vomiting for other COVID-19 symptoms: Patients should inform gastroenterologists if they begin to experience new fever, cough, shortness of breath, or other upper respiratory infection symptoms after the onset of GI symptoms. If this occurs, testing for COVID-19 should be considered.
• Abnormalities in liver function tests should prompt thorough evaluation: Liver test abnormalities can be seen in COVID-19 (in approximately 15% of patients); however, available data support that these abnormalities are more commonly attributable to secondary effects from severe disease, rather than primary virus-mediated liver injury. Therefore, it is important to consider alternative etiologies, such as viral hepatitis, when new elevations in aminotransferases are observed.

For all seven evidence-based recommendations and a detailed discussion, review the full publication in Gastroenterology.
 

Authors: Shahnaz Sultan, Osama Altayar, Shazia M. Siddique, Perica Davitkov, Joseph D. Feuerstein, Joseph K. Lim, Yngve Falck-Ytter, Hashem B. El-Serag on behalf of the AGA.

[email protected]

AGA has published new expert recommendations in Gastroenterology: AGA Institute Rapid Review of the GI and Liver Manifestations of COVID-19, Meta-Analysis of International Data, and Recommendations for the Consultative Management of Patients with COVID-19.

Key guidance for gastroenterologists:

• GI symptoms are not as common in COVID-19 as previously estimated: The overall prevalence was 7.7% (95% CI 7.4 to 8.6%) for diarrhea, 7.8% (95% CI: 7.1 to 8.5%) for nausea/vomiting, and 3.6% (95% CI 3.0 to 4.3%) for abdominal pain. Notably, in outpatients, the pooled prevalence of diarrhea is lower (4.0%).
• However, COVID-19 can present atypically, with GI symptoms: COVID-19 can present with diarrhea as an initial symptom, with a pooled prevalence of 7.9% across 35 studies, encompassing 9,717 patients. Most often, diarrhea is accompanied by other upper respiratory infection symptoms. However, in some cases, diarrhea can precede other symptoms by a few days, and COVID-19 may present as isolated GI symptoms prior to the development of upper respiratory infection symptoms.
• Monitor patients with new diarrhea, nausea, or vomiting for other COVID-19 symptoms: Patients should inform gastroenterologists if they begin to experience new fever, cough, shortness of breath, or other upper respiratory infection symptoms after the onset of GI symptoms. If this occurs, testing for COVID-19 should be considered.
• Abnormalities in liver function tests should prompt thorough evaluation: Liver test abnormalities can be seen in COVID-19 (in approximately 15% of patients); however, available data support that these abnormalities are more commonly attributable to secondary effects from severe disease, rather than primary virus-mediated liver injury. Therefore, it is important to consider alternative etiologies, such as viral hepatitis, when new elevations in aminotransferases are observed.

For all seven evidence-based recommendations and a detailed discussion, review the full publication in Gastroenterology.
 

Authors: Shahnaz Sultan, Osama Altayar, Shazia M. Siddique, Perica Davitkov, Joseph D. Feuerstein, Joseph K. Lim, Yngve Falck-Ytter, Hashem B. El-Serag on behalf of the AGA.

[email protected]

AGA has published new expert recommendations in Gastroenterology: AGA Institute Rapid Review of the GI and Liver Manifestations of COVID-19, Meta-Analysis of International Data, and Recommendations for the Consultative Management of Patients with COVID-19.

Key guidance for gastroenterologists:

• GI symptoms are not as common in COVID-19 as previously estimated: The overall prevalence was 7.7% (95% CI 7.4 to 8.6%) for diarrhea, 7.8% (95% CI: 7.1 to 8.5%) for nausea/vomiting, and 3.6% (95% CI 3.0 to 4.3%) for abdominal pain. Notably, in outpatients, the pooled prevalence of diarrhea is lower (4.0%).
• However, COVID-19 can present atypically, with GI symptoms: COVID-19 can present with diarrhea as an initial symptom, with a pooled prevalence of 7.9% across 35 studies, encompassing 9,717 patients. Most often, diarrhea is accompanied by other upper respiratory infection symptoms. However, in some cases, diarrhea can precede other symptoms by a few days, and COVID-19 may present as isolated GI symptoms prior to the development of upper respiratory infection symptoms.
• Monitor patients with new diarrhea, nausea, or vomiting for other COVID-19 symptoms: Patients should inform gastroenterologists if they begin to experience new fever, cough, shortness of breath, or other upper respiratory infection symptoms after the onset of GI symptoms. If this occurs, testing for COVID-19 should be considered.
• Abnormalities in liver function tests should prompt thorough evaluation: Liver test abnormalities can be seen in COVID-19 (in approximately 15% of patients); however, available data support that these abnormalities are more commonly attributable to secondary effects from severe disease, rather than primary virus-mediated liver injury. Therefore, it is important to consider alternative etiologies, such as viral hepatitis, when new elevations in aminotransferases are observed.

For all seven evidence-based recommendations and a detailed discussion, review the full publication in Gastroenterology.
 

Authors: Shahnaz Sultan, Osama Altayar, Shazia M. Siddique, Perica Davitkov, Joseph D. Feuerstein, Joseph K. Lim, Yngve Falck-Ytter, Hashem B. El-Serag on behalf of the AGA.

[email protected]

AGA has advocated for provisions to protect our providers and businesses and we’re happy to report that the following provisions are in the third installation of the COVID-19 economic relief legislation.

We’ll continue to push for direct funding for physicians recognizing that many practices and ASCs are struggling.
 

Small business relief

• Small Business Administration (SBA) loans:

Businesses with 500 employees or less are eligible unless the covered industry’s SBA size standard allows more than 500 employees.

Allows 501(c)(3) non-profits to gain access to the program.

Increases the maximum loan amount to $10 million.

Expands allowable uses of loans to include payroll support, such as:

1. Paid sick or medical leave.

2. Employee salaries.

3. Mortgage payments.

Provides a process for loan forgiveness for certain payroll costs as well as mortgage, rent and utility obligations.

• Public Health and Social Services Emergency Fund:

$100 billion for health care services related to the COVID-19.

Reimbursement to eligible health care providers for health care related expenses or lost revenues that are attributable to the pandemic.

• Coronavirus Economic Stabilization Act:

$454 billion for loans, loan guarantees and other investments for companies with losses tied to the pandemic that threaten continued operation.
 

Medicare provisions

• Suspension of sequestration – Physicians avoid a 2% cut in their Medicare reimbursement.
• Extension of geographic index floor – Increases Medicare payments for providers in nonurban areas.
• Increased Medicare telehealth flexibilities during the emergency period.
• AGA will continue to advocate for audio-only coverage as this issue is still not resolved.

Other key health care provisions

• Liability protections for health care professionals during the emergency response.
• Coverage of preventive services and vaccines.
• $16 billion to replenish the Strategic National Stockpile.
• $1 billion for the Defense Production Act to ensure production of personal protective equipment (PPE).

Correspondence to congressional leadership

• March 25, 2020 – With the American Medical Association, a letter is sent requesting the inclusion of support for physician practices in any economic stimulus package.
• March 24, 2020 – With the Alliance of Specialty Medicine, a letter is sent asking for relief for independent physicians’ offices.
• March 20, 2020 – A joint society letter is sent asking for increased funding for and access to PPE; softened prior authorization, telehealth reimbursement and Medicare reporting requirements; and financial safeguards for health care professionals and practices.

[email protected]

AGA has advocated for provisions to protect our providers and businesses and we’re happy to report that the following provisions are in the third installation of the COVID-19 economic relief legislation.

We’ll continue to push for direct funding for physicians recognizing that many practices and ASCs are struggling.
 

Small business relief

• Small Business Administration (SBA) loans:

Businesses with 500 employees or less are eligible unless the covered industry’s SBA size standard allows more than 500 employees.

Allows 501(c)(3) non-profits to gain access to the program.

Increases the maximum loan amount to $10 million.

Expands allowable uses of loans to include payroll support, such as:

1. Paid sick or medical leave.

2. Employee salaries.

3. Mortgage payments.

Provides a process for loan forgiveness for certain payroll costs as well as mortgage, rent and utility obligations.

• Public Health and Social Services Emergency Fund:

$100 billion for health care services related to the COVID-19.

Reimbursement to eligible health care providers for health care related expenses or lost revenues that are attributable to the pandemic.

• Coronavirus Economic Stabilization Act:

$454 billion for loans, loan guarantees and other investments for companies with losses tied to the pandemic that threaten continued operation.
 

Medicare provisions

• Suspension of sequestration – Physicians avoid a 2% cut in their Medicare reimbursement.
• Extension of geographic index floor – Increases Medicare payments for providers in nonurban areas.
• Increased Medicare telehealth flexibilities during the emergency period.
• AGA will continue to advocate for audio-only coverage as this issue is still not resolved.

Other key health care provisions

• Liability protections for health care professionals during the emergency response.
• Coverage of preventive services and vaccines.
• $16 billion to replenish the Strategic National Stockpile.
• $1 billion for the Defense Production Act to ensure production of personal protective equipment (PPE).

Correspondence to congressional leadership

• March 25, 2020 – With the American Medical Association, a letter is sent requesting the inclusion of support for physician practices in any economic stimulus package.
• March 24, 2020 – With the Alliance of Specialty Medicine, a letter is sent asking for relief for independent physicians’ offices.
• March 20, 2020 – A joint society letter is sent asking for increased funding for and access to PPE; softened prior authorization, telehealth reimbursement and Medicare reporting requirements; and financial safeguards for health care professionals and practices.

[email protected]

AGA has advocated for provisions to protect our providers and businesses and we’re happy to report that the following provisions are in the third installation of the COVID-19 economic relief legislation.

We’ll continue to push for direct funding for physicians recognizing that many practices and ASCs are struggling.
 

Small business relief

• Small Business Administration (SBA) loans:

Businesses with 500 employees or less are eligible unless the covered industry’s SBA size standard allows more than 500 employees.

Allows 501(c)(3) non-profits to gain access to the program.

Increases the maximum loan amount to $10 million.

Expands allowable uses of loans to include payroll support, such as:

1. Paid sick or medical leave.

2. Employee salaries.

3. Mortgage payments.

Provides a process for loan forgiveness for certain payroll costs as well as mortgage, rent and utility obligations.

• Public Health and Social Services Emergency Fund:

$100 billion for health care services related to the COVID-19.

Reimbursement to eligible health care providers for health care related expenses or lost revenues that are attributable to the pandemic.

• Coronavirus Economic Stabilization Act:

$454 billion for loans, loan guarantees and other investments for companies with losses tied to the pandemic that threaten continued operation.
 

Medicare provisions

• Suspension of sequestration – Physicians avoid a 2% cut in their Medicare reimbursement.
• Extension of geographic index floor – Increases Medicare payments for providers in nonurban areas.
• Increased Medicare telehealth flexibilities during the emergency period.
• AGA will continue to advocate for audio-only coverage as this issue is still not resolved.

Other key health care provisions

• Liability protections for health care professionals during the emergency response.
• Coverage of preventive services and vaccines.
• $16 billion to replenish the Strategic National Stockpile.
• $1 billion for the Defense Production Act to ensure production of personal protective equipment (PPE).

Correspondence to congressional leadership

• March 25, 2020 – With the American Medical Association, a letter is sent requesting the inclusion of support for physician practices in any economic stimulus package.
• March 24, 2020 – With the Alliance of Specialty Medicine, a letter is sent asking for relief for independent physicians’ offices.
• March 20, 2020 – A joint society letter is sent asking for increased funding for and access to PPE; softened prior authorization, telehealth reimbursement and Medicare reporting requirements; and financial safeguards for health care professionals and practices.

[email protected]

Dear colleagues,

The coronavirus pandemic has affected every facet of society, bringing almost unprecedented challenges to our world, and especially to our world of health care.

But our profession has been ignited in the way only a crisis can spark. Many of you are working on the front lines of patient care, at personal risk, lacking sufficient information and adequate resources. This is heroic work.

AGA’s priority during this time of disruption is to get practical guidance into your hands to help you treat patients, and protect yourselves and your coworkers. We’re also advocating on your behalf to get the resources you need and economic relief necessitated by the measures taken to fight the pandemic.

We are continually updating our COVID-19 website, www.gastro.org/covid. Check it for the latest clinical guidance, practice management information, and advocacy initiatives.

Our journals have started a collection of submissions related to COVID-19. Your AGA colleagues on the Clinical Guidelines Committee and Clinical Practice Updates Committee have been hard at work developing guidance for questions that you have asked us on Twitter, @AmerGastroAssn and the AGA Community. So join us there where resources and insights are being shared in real time.

Your commitment to our patients is a testament to your professionalism. Our commitment at AGA is to support you.

We’ll get through this together.
 

Hashem B. El-Serag, MD, MPH, AGAF
President, AGA Institute

Dear colleagues,

The coronavirus pandemic has affected every facet of society, bringing almost unprecedented challenges to our world, and especially to our world of health care.

But our profession has been ignited in the way only a crisis can spark. Many of you are working on the front lines of patient care, at personal risk, lacking sufficient information and adequate resources. This is heroic work.

AGA’s priority during this time of disruption is to get practical guidance into your hands to help you treat patients, and protect yourselves and your coworkers. We’re also advocating on your behalf to get the resources you need and economic relief necessitated by the measures taken to fight the pandemic.

We are continually updating our COVID-19 website, www.gastro.org/covid. Check it for the latest clinical guidance, practice management information, and advocacy initiatives.

Our journals have started a collection of submissions related to COVID-19. Your AGA colleagues on the Clinical Guidelines Committee and Clinical Practice Updates Committee have been hard at work developing guidance for questions that you have asked us on Twitter, @AmerGastroAssn and the AGA Community. So join us there where resources and insights are being shared in real time.

Your commitment to our patients is a testament to your professionalism. Our commitment at AGA is to support you.

We’ll get through this together.
 

Hashem B. El-Serag, MD, MPH, AGAF
President, AGA Institute

Dear colleagues,

The coronavirus pandemic has affected every facet of society, bringing almost unprecedented challenges to our world, and especially to our world of health care.

But our profession has been ignited in the way only a crisis can spark. Many of you are working on the front lines of patient care, at personal risk, lacking sufficient information and adequate resources. This is heroic work.

AGA’s priority during this time of disruption is to get practical guidance into your hands to help you treat patients, and protect yourselves and your coworkers. We’re also advocating on your behalf to get the resources you need and economic relief necessitated by the measures taken to fight the pandemic.

We are continually updating our COVID-19 website, www.gastro.org/covid. Check it for the latest clinical guidance, practice management information, and advocacy initiatives.

Our journals have started a collection of submissions related to COVID-19. Your AGA colleagues on the Clinical Guidelines Committee and Clinical Practice Updates Committee have been hard at work developing guidance for questions that you have asked us on Twitter, @AmerGastroAssn and the AGA Community. So join us there where resources and insights are being shared in real time.

Your commitment to our patients is a testament to your professionalism. Our commitment at AGA is to support you.

We’ll get through this together.
 

Hashem B. El-Serag, MD, MPH, AGAF
President, AGA Institute

Based on a review of available evidence, we have published guidance for clinicians in gastroenterology: AGA Institute Rapid Recommendations for Gastrointestinal Procedures During the COVID-19 Pandemic. AGA recommends increasing personal protective equipment (PPE) during all GI procedures during the coronavirus pandemic, as well as triaging procedures following a decision-making framework outlined in the recommendations document.

Review this guidance, as well as the latest AGA resources and information on coronavirus, at www.gastro.org/COVID.
 

Masks

1. In health care workers performing upper GI procedures, regardless of COVID-19 status,* AGA recommends use of N95 (or N99 or PAPR) instead of surgical masks, as part of appropriate personal protective equipment. (Strong recommendation, moderate certainty of evidence)

2. In health care workers performing lower GI procedures regardless of COVID-19 status,* AGA recommends the use of N95 (or N99 or PAPR) masks instead of surgical masks as part of appropriate personal protective equipment. (Strong recommendation, low certainty of evidence)

3. In health care workers performing upper GI procedures, in known or presumptive COVID-19 patients, AGA recommends against the use of surgical masks only, as part of adequate personal protective equipment. (Strong recommendation, low certainty of evidence)
 

Limited resource settings

4. In extreme resource-constrained settings involving health care workers performing any GI procedures, regardless of COVID-19 status,* AGA suggests extended use/re-use of N95 masks over surgical masks, as part of appropriate personal protective equipment. (Conditional recommendation, very low certainty evidence)
 

Gloves

5. In health care workers performing any GI procedure, regardless of COVID-19 status, AGA recommends the use of double gloves compared with single gloves as part of appropriate personal protective equipment. (Strong recommendation, moderate certainty of evidence)
 

Negative pressure rooms

6. In health care workers performing any GI procedures with known or presumptive COVID-19, AGA suggests the use of negative pressure rooms over regular endoscopy rooms when available. (Conditional recommendation, very low certainty of evidence)
 

Endoscopic disinfection

7. For endoscopes utilized on patients regardless of COVID-status, AGA recommends continuing standard cleaning endoscopic disinfection and reprocessing protocols. (Good practice statement)
 

Triage

8. All procedures should be reviewed by trained medical personnel and categorized as time-sensitive or not time-sensitive as a framework for triaging procedures. (Good practice statement)

9. In an open access endoscopy system where the listed indication alone may provide insufficient information to make a determination about the time-sensitive nature of the procedure, consideration should be given for the following options (i) a telephone consultation with the referring provider or (ii) a telehealth visit with the patient or (iii) a multidisciplinary team approach to facilitate decision-making for complicated patients. (Good practice statement)


*These recommendations assume the absence of widespread reliable rapid testing for the diagnosis of COVID-19 infection or immunity

For a detailed discussion, review the full publication in Gastroenterology.

This rapid recommendation document was commissioned and approved by the AGA Institute Clinical Guidelines Committee, AGA Institute Clinical Practice Updates Committee, and the AGA Governing Board to provide timely, methodologically rigorous guidance on a topic of high clinical importance to the AGA membership and the public. Our goal is to protect health care providers and patients from coronavirus during GI procedures.
 

[email protected]

Based on a review of available evidence, we have published guidance for clinicians in gastroenterology: AGA Institute Rapid Recommendations for Gastrointestinal Procedures During the COVID-19 Pandemic. AGA recommends increasing personal protective equipment (PPE) during all GI procedures during the coronavirus pandemic, as well as triaging procedures following a decision-making framework outlined in the recommendations document.

Review this guidance, as well as the latest AGA resources and information on coronavirus, at www.gastro.org/COVID.
 

Masks

1. In health care workers performing upper GI procedures, regardless of COVID-19 status,* AGA recommends use of N95 (or N99 or PAPR) instead of surgical masks, as part of appropriate personal protective equipment. (Strong recommendation, moderate certainty of evidence)

2. In health care workers performing lower GI procedures regardless of COVID-19 status,* AGA recommends the use of N95 (or N99 or PAPR) masks instead of surgical masks as part of appropriate personal protective equipment. (Strong recommendation, low certainty of evidence)

3. In health care workers performing upper GI procedures, in known or presumptive COVID-19 patients, AGA recommends against the use of surgical masks only, as part of adequate personal protective equipment. (Strong recommendation, low certainty of evidence)
 

Limited resource settings

4. In extreme resource-constrained settings involving health care workers performing any GI procedures, regardless of COVID-19 status,* AGA suggests extended use/re-use of N95 masks over surgical masks, as part of appropriate personal protective equipment. (Conditional recommendation, very low certainty evidence)
 

Gloves

5. In health care workers performing any GI procedure, regardless of COVID-19 status, AGA recommends the use of double gloves compared with single gloves as part of appropriate personal protective equipment. (Strong recommendation, moderate certainty of evidence)
 

Negative pressure rooms

6. In health care workers performing any GI procedures with known or presumptive COVID-19, AGA suggests the use of negative pressure rooms over regular endoscopy rooms when available. (Conditional recommendation, very low certainty of evidence)
 

Endoscopic disinfection

7. For endoscopes utilized on patients regardless of COVID-status, AGA recommends continuing standard cleaning endoscopic disinfection and reprocessing protocols. (Good practice statement)
 

Triage

8. All procedures should be reviewed by trained medical personnel and categorized as time-sensitive or not time-sensitive as a framework for triaging procedures. (Good practice statement)

9. In an open access endoscopy system where the listed indication alone may provide insufficient information to make a determination about the time-sensitive nature of the procedure, consideration should be given for the following options (i) a telephone consultation with the referring provider or (ii) a telehealth visit with the patient or (iii) a multidisciplinary team approach to facilitate decision-making for complicated patients. (Good practice statement)


*These recommendations assume the absence of widespread reliable rapid testing for the diagnosis of COVID-19 infection or immunity

For a detailed discussion, review the full publication in Gastroenterology.

This rapid recommendation document was commissioned and approved by the AGA Institute Clinical Guidelines Committee, AGA Institute Clinical Practice Updates Committee, and the AGA Governing Board to provide timely, methodologically rigorous guidance on a topic of high clinical importance to the AGA membership and the public. Our goal is to protect health care providers and patients from coronavirus during GI procedures.
 

[email protected]

Based on a review of available evidence, we have published guidance for clinicians in gastroenterology: AGA Institute Rapid Recommendations for Gastrointestinal Procedures During the COVID-19 Pandemic. AGA recommends increasing personal protective equipment (PPE) during all GI procedures during the coronavirus pandemic, as well as triaging procedures following a decision-making framework outlined in the recommendations document.

Review this guidance, as well as the latest AGA resources and information on coronavirus, at www.gastro.org/COVID.
 

Masks

1. In health care workers performing upper GI procedures, regardless of COVID-19 status,* AGA recommends use of N95 (or N99 or PAPR) instead of surgical masks, as part of appropriate personal protective equipment. (Strong recommendation, moderate certainty of evidence)

2. In health care workers performing lower GI procedures regardless of COVID-19 status,* AGA recommends the use of N95 (or N99 or PAPR) masks instead of surgical masks as part of appropriate personal protective equipment. (Strong recommendation, low certainty of evidence)

3. In health care workers performing upper GI procedures, in known or presumptive COVID-19 patients, AGA recommends against the use of surgical masks only, as part of adequate personal protective equipment. (Strong recommendation, low certainty of evidence)
 

Limited resource settings

4. In extreme resource-constrained settings involving health care workers performing any GI procedures, regardless of COVID-19 status,* AGA suggests extended use/re-use of N95 masks over surgical masks, as part of appropriate personal protective equipment. (Conditional recommendation, very low certainty evidence)
 

Gloves

5. In health care workers performing any GI procedure, regardless of COVID-19 status, AGA recommends the use of double gloves compared with single gloves as part of appropriate personal protective equipment. (Strong recommendation, moderate certainty of evidence)
 

Negative pressure rooms

6. In health care workers performing any GI procedures with known or presumptive COVID-19, AGA suggests the use of negative pressure rooms over regular endoscopy rooms when available. (Conditional recommendation, very low certainty of evidence)
 

Endoscopic disinfection

7. For endoscopes utilized on patients regardless of COVID-status, AGA recommends continuing standard cleaning endoscopic disinfection and reprocessing protocols. (Good practice statement)
 

Triage

8. All procedures should be reviewed by trained medical personnel and categorized as time-sensitive or not time-sensitive as a framework for triaging procedures. (Good practice statement)

9. In an open access endoscopy system where the listed indication alone may provide insufficient information to make a determination about the time-sensitive nature of the procedure, consideration should be given for the following options (i) a telephone consultation with the referring provider or (ii) a telehealth visit with the patient or (iii) a multidisciplinary team approach to facilitate decision-making for complicated patients. (Good practice statement)


*These recommendations assume the absence of widespread reliable rapid testing for the diagnosis of COVID-19 infection or immunity

For a detailed discussion, review the full publication in Gastroenterology.

This rapid recommendation document was commissioned and approved by the AGA Institute Clinical Guidelines Committee, AGA Institute Clinical Practice Updates Committee, and the AGA Governing Board to provide timely, methodologically rigorous guidance on a topic of high clinical importance to the AGA membership and the public. Our goal is to protect health care providers and patients from coronavirus during GI procedures.
 

[email protected]

Physicians with difficult patient scenarios regularly bring their questions to the AGA Community to seek advice from colleagues about therapy and disease management options, best practices, and diagnoses.

Here are some recent discussions addressing clinical concerns and issues arising from the COVID-19 epidemic:

eQ&A on recommendations for GI procedures during the COVID-19 pandemic – Join guideline authors in discussing AGA Institute Rapid Recommendations for Gastrointestinal Procedures During the COVID-19 Pandemic, published in Gastroenterology.



1. IBD patients and COVID-19 – To allow for timely dissemination throughout the IBD and international gastroenterology communities, members are sharing important updates regarding COVID-19 and IBD management.



2. Medicare COVID-19 changes and telehealth reimbursement – Share your experiences and difficulties using telehealth platforms like Skype and facetime to connect with Medicare beneficiaries during the coronavirus epidemic.



3. Anesthesia options for in-patient endoscopy – Colleagues examine whether intubation is the best approach for EGDs to minimize COVID-19 transmission risk.



Access these and more discussions at https://community.gastro.org/discussions.

Physicians with difficult patient scenarios regularly bring their questions to the AGA Community to seek advice from colleagues about therapy and disease management options, best practices, and diagnoses.

Here are some recent discussions addressing clinical concerns and issues arising from the COVID-19 epidemic:

eQ&A on recommendations for GI procedures during the COVID-19 pandemic – Join guideline authors in discussing AGA Institute Rapid Recommendations for Gastrointestinal Procedures During the COVID-19 Pandemic, published in Gastroenterology.



1. IBD patients and COVID-19 – To allow for timely dissemination throughout the IBD and international gastroenterology communities, members are sharing important updates regarding COVID-19 and IBD management.



2. Medicare COVID-19 changes and telehealth reimbursement – Share your experiences and difficulties using telehealth platforms like Skype and facetime to connect with Medicare beneficiaries during the coronavirus epidemic.



3. Anesthesia options for in-patient endoscopy – Colleagues examine whether intubation is the best approach for EGDs to minimize COVID-19 transmission risk.



Access these and more discussions at https://community.gastro.org/discussions.

Physicians with difficult patient scenarios regularly bring their questions to the AGA Community to seek advice from colleagues about therapy and disease management options, best practices, and diagnoses.

Here are some recent discussions addressing clinical concerns and issues arising from the COVID-19 epidemic:

eQ&A on recommendations for GI procedures during the COVID-19 pandemic – Join guideline authors in discussing AGA Institute Rapid Recommendations for Gastrointestinal Procedures During the COVID-19 Pandemic, published in Gastroenterology.



1. IBD patients and COVID-19 – To allow for timely dissemination throughout the IBD and international gastroenterology communities, members are sharing important updates regarding COVID-19 and IBD management.



2. Medicare COVID-19 changes and telehealth reimbursement – Share your experiences and difficulties using telehealth platforms like Skype and facetime to connect with Medicare beneficiaries during the coronavirus epidemic.



3. Anesthesia options for in-patient endoscopy – Colleagues examine whether intubation is the best approach for EGDs to minimize COVID-19 transmission risk.



Access these and more discussions at https://community.gastro.org/discussions.

Disregard what is currently accepted as state of the art, reimagine the present as an imperfect stepping stone, and envision a future in which colorectal cancer (CRC) screening and surveillance are optimized. This was the direction for attendees of AGA’s consensus conference — Colorectal Cancer Screening and Surveillance: Role of Emerging Technology and Innovation to Improve Outcomes.

The AGA Center for GI Innovation and Technology invited leading academic and industry experts to a working meeting to identify barriers to the optimization of CRC screening and surveillance, and to define a roadmap for overcoming these barriers.
 

Meeting conclusions

Although colonoscopy is widely considered to be an excellent tool for CRC screening and surveillance, barriers to optimal effectiveness exist. Barriers include lack of access to health care, financial cost, suboptimal uptake even among individuals with health insurance and financial resources, imperfect adherence to guidelines, and development of early-age, and interval cancers despite adherence to guidelines.

Novel cost-effective, sensitive, specific, and personalized strategies are needed to address these barriers.

To read about the emerging technologies discussed at the meeting, review the meeting summary in Gastroenterology.
 

[email protected]

Disregard what is currently accepted as state of the art, reimagine the present as an imperfect stepping stone, and envision a future in which colorectal cancer (CRC) screening and surveillance are optimized. This was the direction for attendees of AGA’s consensus conference — Colorectal Cancer Screening and Surveillance: Role of Emerging Technology and Innovation to Improve Outcomes.

The AGA Center for GI Innovation and Technology invited leading academic and industry experts to a working meeting to identify barriers to the optimization of CRC screening and surveillance, and to define a roadmap for overcoming these barriers.
 

Meeting conclusions

Although colonoscopy is widely considered to be an excellent tool for CRC screening and surveillance, barriers to optimal effectiveness exist. Barriers include lack of access to health care, financial cost, suboptimal uptake even among individuals with health insurance and financial resources, imperfect adherence to guidelines, and development of early-age, and interval cancers despite adherence to guidelines.

Novel cost-effective, sensitive, specific, and personalized strategies are needed to address these barriers.

To read about the emerging technologies discussed at the meeting, review the meeting summary in Gastroenterology.
 

[email protected]

Disregard what is currently accepted as state of the art, reimagine the present as an imperfect stepping stone, and envision a future in which colorectal cancer (CRC) screening and surveillance are optimized. This was the direction for attendees of AGA’s consensus conference — Colorectal Cancer Screening and Surveillance: Role of Emerging Technology and Innovation to Improve Outcomes.

The AGA Center for GI Innovation and Technology invited leading academic and industry experts to a working meeting to identify barriers to the optimization of CRC screening and surveillance, and to define a roadmap for overcoming these barriers.
 

Meeting conclusions

Although colonoscopy is widely considered to be an excellent tool for CRC screening and surveillance, barriers to optimal effectiveness exist. Barriers include lack of access to health care, financial cost, suboptimal uptake even among individuals with health insurance and financial resources, imperfect adherence to guidelines, and development of early-age, and interval cancers despite adherence to guidelines.

Novel cost-effective, sensitive, specific, and personalized strategies are needed to address these barriers.

To read about the emerging technologies discussed at the meeting, review the meeting summary in Gastroenterology.
 

[email protected]

Physicians with difficult patient scenarios regularly bring their questions to the AGA Community (https://community.gastro.org) to seek advice from colleagues about therapy and disease management options, best practices, and diagnoses.

Here are some recent clinical discussions in the forum regarding the coronavirus and your patients:

1. Biologic treatment for IBD in the COVID-19 era (http://ow.ly/9akD50yKW8E)

A GI colleague from Italy asks how others are managing IBD patients on ongoing biologic treatment during the coronavirus pandemic.

2. COVID-19 and colonoscopy (http://ow.ly/uYUD50yKWfS)

AGA members discuss recommendations for infection control in endoscopy centers.

3. IBD patients concerned about visiting infusion centers (http://ow.ly/gKED50yKWVZ)

How would you address patient concerns about picking up coronavirus from asymptomatic carriers at bustling infusion centers?



Join these discussions and more at https://community.gastro.org/discussions.

Physicians with difficult patient scenarios regularly bring their questions to the AGA Community (https://community.gastro.org) to seek advice from colleagues about therapy and disease management options, best practices, and diagnoses.

Here are some recent clinical discussions in the forum regarding the coronavirus and your patients:

1. Biologic treatment for IBD in the COVID-19 era (http://ow.ly/9akD50yKW8E)

A GI colleague from Italy asks how others are managing IBD patients on ongoing biologic treatment during the coronavirus pandemic.

2. COVID-19 and colonoscopy (http://ow.ly/uYUD50yKWfS)

AGA members discuss recommendations for infection control in endoscopy centers.

3. IBD patients concerned about visiting infusion centers (http://ow.ly/gKED50yKWVZ)

How would you address patient concerns about picking up coronavirus from asymptomatic carriers at bustling infusion centers?



Join these discussions and more at https://community.gastro.org/discussions.

Physicians with difficult patient scenarios regularly bring their questions to the AGA Community (https://community.gastro.org) to seek advice from colleagues about therapy and disease management options, best practices, and diagnoses.

Here are some recent clinical discussions in the forum regarding the coronavirus and your patients:

1. Biologic treatment for IBD in the COVID-19 era (http://ow.ly/9akD50yKW8E)

A GI colleague from Italy asks how others are managing IBD patients on ongoing biologic treatment during the coronavirus pandemic.

2. COVID-19 and colonoscopy (http://ow.ly/uYUD50yKWfS)

AGA members discuss recommendations for infection control in endoscopy centers.

3. IBD patients concerned about visiting infusion centers (http://ow.ly/gKED50yKWVZ)

How would you address patient concerns about picking up coronavirus from asymptomatic carriers at bustling infusion centers?



Join these discussions and more at https://community.gastro.org/discussions.

AGA has partnered with Rx.Health, a digital health company, to create a colorectal cancer (CRC) preparatory app.

You want to find ways to improve your patient outcomes and reduce your practice costs? Now, there is an app for that. The CRC preparatory app can reduce expenses you lose from aborted or incomplete colonoscopies.

Launched in 2019, the CRC app is already generating remarkable results. The Arizona Center for Digestive Health used the CRC app and recorded a 24% improvement in bowel preparation by colonoscopy patients, a 50% reduction in aborted procedures and a 93% patient satisfaction rate. Research conducted by Rx.Health also determined patients were using the CRC app two to four times longer than competing apps, and the CRC app was saving gastroenterologists between $20,000 and $40,000 annually.

Plans are underway between AGA and Rx.Health to expand the partnership to build apps for colorectal cancer surveillance, an inflammatory bowel disease (IBD) registry, fecal microbiota transplantation (FMT), and other GI disorders.

Interested in learning more? Visit rx.health/gi.

[email protected]

AGA has partnered with Rx.Health, a digital health company, to create a colorectal cancer (CRC) preparatory app.

You want to find ways to improve your patient outcomes and reduce your practice costs? Now, there is an app for that. The CRC preparatory app can reduce expenses you lose from aborted or incomplete colonoscopies.

Launched in 2019, the CRC app is already generating remarkable results. The Arizona Center for Digestive Health used the CRC app and recorded a 24% improvement in bowel preparation by colonoscopy patients, a 50% reduction in aborted procedures and a 93% patient satisfaction rate. Research conducted by Rx.Health also determined patients were using the CRC app two to four times longer than competing apps, and the CRC app was saving gastroenterologists between $20,000 and $40,000 annually.

Plans are underway between AGA and Rx.Health to expand the partnership to build apps for colorectal cancer surveillance, an inflammatory bowel disease (IBD) registry, fecal microbiota transplantation (FMT), and other GI disorders.

Interested in learning more? Visit rx.health/gi.

[email protected]

AGA has partnered with Rx.Health, a digital health company, to create a colorectal cancer (CRC) preparatory app.

You want to find ways to improve your patient outcomes and reduce your practice costs? Now, there is an app for that. The CRC preparatory app can reduce expenses you lose from aborted or incomplete colonoscopies.

Launched in 2019, the CRC app is already generating remarkable results. The Arizona Center for Digestive Health used the CRC app and recorded a 24% improvement in bowel preparation by colonoscopy patients, a 50% reduction in aborted procedures and a 93% patient satisfaction rate. Research conducted by Rx.Health also determined patients were using the CRC app two to four times longer than competing apps, and the CRC app was saving gastroenterologists between $20,000 and $40,000 annually.

Plans are underway between AGA and Rx.Health to expand the partnership to build apps for colorectal cancer surveillance, an inflammatory bowel disease (IBD) registry, fecal microbiota transplantation (FMT), and other GI disorders.

Interested in learning more? Visit rx.health/gi.

[email protected]

The recent explosion of innovations for the diagnosis and treatment of GI diseases makes it difficult to identify what will affect you today and what has implications for tomorrow.

Techniques and Innovations in Gastrointestinal Endoscopy (TIGE) cuts through the noise with quarterly updates featuring groundbreaking advances in GI endoscopy. Previously known as Techniques in Gastrointestinal Endoscopy, TIGE is the newest member of the AGA journal family and illuminates the next generation of technologies in an easily accessible, online-only format. TIGE will continue to be led by Co-Editors-in-Chief Vinay Chandrasekhara, MD, Mayo Clinic, Rochester, Minn., and Michael Kochman, MD, AGAF, University of Pennsylvania School of Medicine, Philadelphia, and a hand-selected editorial board of leaders in GI endoscopy.

Check out the current issue of TIGE focused on how lumen apposing metal stents (LAMS) are changing GI endoscopy. The issue provides a comprehensive review on the current state of LAMS and best practices for using LAMS to optimize patient outcomes.

Discover TIGE at tigejournal.org.
 

[email protected]

The recent explosion of innovations for the diagnosis and treatment of GI diseases makes it difficult to identify what will affect you today and what has implications for tomorrow.

Techniques and Innovations in Gastrointestinal Endoscopy (TIGE) cuts through the noise with quarterly updates featuring groundbreaking advances in GI endoscopy. Previously known as Techniques in Gastrointestinal Endoscopy, TIGE is the newest member of the AGA journal family and illuminates the next generation of technologies in an easily accessible, online-only format. TIGE will continue to be led by Co-Editors-in-Chief Vinay Chandrasekhara, MD, Mayo Clinic, Rochester, Minn., and Michael Kochman, MD, AGAF, University of Pennsylvania School of Medicine, Philadelphia, and a hand-selected editorial board of leaders in GI endoscopy.

Check out the current issue of TIGE focused on how lumen apposing metal stents (LAMS) are changing GI endoscopy. The issue provides a comprehensive review on the current state of LAMS and best practices for using LAMS to optimize patient outcomes.

Discover TIGE at tigejournal.org.
 

[email protected]

The recent explosion of innovations for the diagnosis and treatment of GI diseases makes it difficult to identify what will affect you today and what has implications for tomorrow.

Techniques and Innovations in Gastrointestinal Endoscopy (TIGE) cuts through the noise with quarterly updates featuring groundbreaking advances in GI endoscopy. Previously known as Techniques in Gastrointestinal Endoscopy, TIGE is the newest member of the AGA journal family and illuminates the next generation of technologies in an easily accessible, online-only format. TIGE will continue to be led by Co-Editors-in-Chief Vinay Chandrasekhara, MD, Mayo Clinic, Rochester, Minn., and Michael Kochman, MD, AGAF, University of Pennsylvania School of Medicine, Philadelphia, and a hand-selected editorial board of leaders in GI endoscopy.

Check out the current issue of TIGE focused on how lumen apposing metal stents (LAMS) are changing GI endoscopy. The issue provides a comprehensive review on the current state of LAMS and best practices for using LAMS to optimize patient outcomes.

Discover TIGE at tigejournal.org.
 

[email protected]

The AGA Governing Board recognizes and shares the extreme uncertainty faced by the GI community regarding the rapidly evolving coronavirus situation. Priority #1 is, as always, keeping our patients and families safe, but we also would like to ensure the safety of our GI health care providers.

COVID-19 is an emerging disease and there is more to learn about its transmission, severity, and how it will take shape in the U.S. We have asked our clinical guidance experts to determine what, if any, GI-specific scientifically valid recommendations can be made. In fact, Gastroenterology has just published papers on GI symptoms and potential fecal transmission in coronavirus patients. You can see this work at www.gastrojournal.org/inpress.

Stay tuned to www.gastro.org and your email for continued updates on coronavirus, as well as information on AGA live events and DDW given the current circumstances.
 

[email protected]

The AGA Governing Board recognizes and shares the extreme uncertainty faced by the GI community regarding the rapidly evolving coronavirus situation. Priority #1 is, as always, keeping our patients and families safe, but we also would like to ensure the safety of our GI health care providers.

COVID-19 is an emerging disease and there is more to learn about its transmission, severity, and how it will take shape in the U.S. We have asked our clinical guidance experts to determine what, if any, GI-specific scientifically valid recommendations can be made. In fact, Gastroenterology has just published papers on GI symptoms and potential fecal transmission in coronavirus patients. You can see this work at www.gastrojournal.org/inpress.

Stay tuned to www.gastro.org and your email for continued updates on coronavirus, as well as information on AGA live events and DDW given the current circumstances.
 

[email protected]

The AGA Governing Board recognizes and shares the extreme uncertainty faced by the GI community regarding the rapidly evolving coronavirus situation. Priority #1 is, as always, keeping our patients and families safe, but we also would like to ensure the safety of our GI health care providers.

COVID-19 is an emerging disease and there is more to learn about its transmission, severity, and how it will take shape in the U.S. We have asked our clinical guidance experts to determine what, if any, GI-specific scientifically valid recommendations can be made. In fact, Gastroenterology has just published papers on GI symptoms and potential fecal transmission in coronavirus patients. You can see this work at www.gastrojournal.org/inpress.

Stay tuned to www.gastro.org and your email for continued updates on coronavirus, as well as information on AGA live events and DDW given the current circumstances.
 

[email protected]