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Practice Parameters Committee

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Training Committee

Training Committee

MEMBERS

David W . Wan, MD, FACG, Chair Neil Sengupta, MD, FACG, Vice Chair Jana G . Al Hashash, MD, FACG Andrea L . Betesh, MD Kathy P . Bull-Henry, MD, MBA, FACG Brooks D . Cash, MD, FACG Adam S . Cheifetz, MD, FACG Steven B . Clayton, MD, FACG Nayantara Coelho-Prabhu, MD, FACG Michelle S . Cohen, MD Shashank Garg, MD Mohit Girotra, MD Katarina B . Greer, MD, MS Epi Ira M . Jacobson, MD, FACG Sofia S . Jakab, MD Arun B . Jesudian, MD, FACG Janice Jou, MD Jonathan S . Levine, MD Berkeley Nguyen Limketkai, MD, PhD, FACG Millie D . Long, MD, MPH, FACG John G . McCarthy, MD Douglas R . Morgan, MD, MPH, FACG Sravanthi Parasa, MD Amit Patel, MD, FACG Anjana A . Pillai, MD, FACG Mark S . Riddle, MD, DrPH, FISTM Douglas J . Robertson, MD, MPH Bryan G . Sauer, MD, MSc (Clin Res), FACG Shervin Shafa, MD Brijen J . Shah, MD Sunil G . Sheth, MD, FACG Eun J . Shin, MD Humberto Sifuentes, MD Ashwani K . Singal, MD, MS, FACG Preetika Sinh, MD Zachary L . Smith, DO Amir Soumekh, MD Jason R . Taylor, MD, FACG Chandrashekhar Thukral, MD, PhD Adam M . Tritsch, MD Jamile Wakim-Fleming, MD, FACG Robert J . Wong, MD, MS, FACG Rena H . Yadlapati, MD, MSHS Mohammad Yaghoobi, MD, FACG David W. Wan, MD, FACG

RESPONSIBILITIES AS STATED IN THE ACG BYLAWS

This Committee shall be responsible for reviewing state-ofthe-art research and establishing peer-reviewed consensus recommendations for publication by the College regarding the then-current viewpoint of several key experts on the treatment of digestive disorders by gastroenterologists and other physicians .

OBJECTIVES

1 . Develop practice guidelines that reflect the current, state-ofthe-art scientific work based on the principles of evidencebased medicine . 2 . Update previously published guidelines as new information becomes available .

COMMITTEE REPORT

This year again was very productive for the Practice Parameters Committee . At the time of this report, five practice guidelines were published in The American Journal of Gastroenterology (AJG) in 2021, four guidelines are being reviewed or are nearing completion, and twenty guidelines are in development .

The following five guidelines were published in AJG in 2021: • Management of Irritable Bowel Syndrome (January 2021) • Colorectal Cancer Screening 2021 (March 2021) • Upper Gastrointestinal and Ulcer Bleeding (May 2021) • Diagnosis and Management of Idiosyncratic Drug-Induced Liver

Injury (May 2021) • Prevention, Diagnosis, and Treatment of Clostridioides difficile

Infections (June 2021)

The following four guidelines are undergoing revisions or are nearing completion: • Management of Benign Anorectal Disorders • Diagnosis and Management of Barrett’s Esophagus • Acute On Chronic Liver Failure • Diagnosis and Management of Gastroesophageal

The following seventeen guidelines are currently in development: • Acute Liver Failure • Acute Lower GI Bleeding • Acute Pancreatitis [Update] • Alcohol-Associated Liver Disease • Approach to Submucosal Masses of the GI Tract • Barrett’s Esophagus • Bariatric Endoscopy • Biliary Strictures • Celiac Disease [Update]

• Complications of ERCP • Gastric Premalignant Conditions • Gastroparesis • Gastrointestinal Polyp Syndrome • Management of Gastroparesis • Nutrition in Liver Disease • Pregnancy in IBD • Submucosal Masses of the GI Tract

The following three guidelines are being developed with other societies . Joint Guidelines • Antiplatelet and Anticoagulation in the Periprocedure Setting .

ACG/CAG (Canadian Association of Gastroenterology) Joint

Publication. • Management of Constipation . ACG/AGA Joint Publication . • Role of Radiology in GI Bleeding . ACG/Society of Radiology

Joint Publication.

IBD Rapid Update/Living Document • A task force and process have been developed to continually update the College’s existing IBD guidelines (Crohn’s Disease,

IBD Preventive Care and Ulcerative Colitis) to keep with the pace of novel, high-impact studies .

For each of the above guidelines, an authoring panel of topic experts will be or has been invited to participate, and a member from the Committee has been assigned to each guideline to assure that the timeline is followed .

Role of the GRADE Methodologists

For each guideline, the GRADE system is utilized to evaluate the strength of the recommendations (from high to low) and the overall quality of evidence (strong or conditional) . The evidencebased statements are highlighted in each section of the guideline and are also summarized at the end of each guideline document . A panel of ACG GRADE team members use the GRADE system software program to assist the authors in assessing the level of evidence for each statement based on assessment of the articles of the highest evidence for each statement . The College has 6 formally trained GRADE methodologists for this role . A new development in 2021 is that the secondary GRADE methodologist can be listed as an author on the publication if they meet the four qualifications of authorship as per the International Committee of Medical Journal Editors (ICMJE) recommendations (http://www . icmje .org/recommendations/browse/roles-and-responsibilities/ defining-the-role-of-authors-and-contributors .html): 1 . Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND 2 . Drafting the work or revising it critically for important intellectual content; AND 3 . Final approval of the version to be published; AND 4 . Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved .

Publication Process

Once each guideline is completed, the publishing process has been streamlined so that reviews are performed by at least two members of the Committee, a member of the ACG Board of Trustees, and an Associate Editor from The American Journal of Gastroenterology (AJG) . The authors then receive a streamlined set of comments in order to direct potential revisions . The final drafts of all guidelines are then reviewed by the entire ACG Board of Trustees prior to publication . All completed guidelines are available on the ACG website and mobile app, as well as PubMed . In addition, the AJG Podcast features interviews with authors of recent published guidelines and a patient-facing segment is recorded for the Patient Care Committee .

The Committee had a virtual Zoom meeting in spring 2021, and is meeting in person at ACG 2021 in Las Vegas on Monday, October 25 .

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