No international consensus found for ‘indiscriminate use’ of single-use endoscopes
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CHICAGO — Although no agreement could be reached for “indiscriminate use” of single-use endoscopes and accessories, single-use endoscopes should be considered for specific tasks, according to data at Digestive Disease Week.
The adoption of single-use endoscopes and accessories have been touted to improve safety in gastrointestinal endoscopy, especially in the face of mounting infectious rate estimates and poor microbiological surveillance globally. However, there remains an absence of data on proper use and sustainability of single-use endoscopes.
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“The advent of single-use scope technology generates the unmet need to understand its potential and clinical indications,” Cesare Hassan, MD, PhD, associate professor of gastroenterology at the Humanitas Research Hospital in Rozzano, Italy, told Healio.
To establish a series of best practice recommendations for single-use endoscopes and accessories, Hassan and colleagues developed consensus statements for single-use endoscopy, using a modified Delphi process and employing a 63-member international endoscopist expert panel from 33 nations.
Patients with multidrug-resistant infections, on immunosuppressive medication or chemotherapy, with severe neutropenia or who had received transplantation were defined as high-risk patients.
According to the researchers, 26 statements were proposed by the expert panel during two rounds of voting, covering single-use accessories, clinical indication for single-use endoscopes, technical factors and environmental issues, as well as financial implications regarding patient safety, infection, climate change and cost. However, of the 26 statements, only 17 statements reached consensus.
“No consensus was found on an indiscriminate use of single-use scopes, but rather a specific application for well-identified clinical needs, such as risk of infection, challenging settings and lack of personnel for disinfection,” Hassan told Healio.
Consensus statements were organized into five categories, including:
- Single-use accessories: Eight statements, related to defining recommendations for the use of single-use accessories in all patient populations or high-risk patients.
- Clinical indication for single-use endoscopes: Nine statements, including indications to high-risk patients, protecting the endoscope apparatus and contamination measures in endoscopy units.
- Technical factors: Four statements related to superior performance and technical specifications of single-use endoscopy.
- Environmental issues: Two statements concerning mechanisms that reduce the negative burden to the environment.
- Financial implications: Three statements related to health care policies, cost neutrality and other financial associations of single-use endoscopy.
As the first international initiative to determine clinical indications for single-use endoscopy and accessories, the researchers noted these findings could provide a framework for physicians to implement single-use endoscopes in clinical practice.
“Single-use scopes should be considered as a clinically relevant alternative for narrow and specific tasks,” Hassan told Healio. “Single-use scopes may increase the safety and capacity of endoscopy [but] we need to understand the additional value in the context.”
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Khalaf K, et al. Abstract Su1085: International Delphi consensus study on disposable single-use endoscopy: A path to clinical adoption. Presented at: Digestive Disease Week; May 6-9, 2023; Chicago (hybrid).
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