BMJ Open Gastroenterology最新文献

{"title":"Cardiovascular health assessed by Life's Essential 8 score, genetic risk, colonoscopy status, and risk of colorectal cancer: an analysis of UK Biobank.","authors":"Chengmiao Qiu, Mengyang Wang, Shujuan Lin, Yang Zhong, Miaomiao Fan, Hao Chen, Liyong Chen, Hao Bai","doi":"10.1136/bmjgast-2025-002010","DOIUrl":"10.1136/bmjgast-2025-002010","url":null,"abstract":"<p><strong>Objective: </strong>Colorectal cancer (CRC) and cardiovascular disease (CVD) share common risk factors. This study explores the association between cardiovascular health (CVH), assessed using the Life's Essential 8 (LE8) score, and CRC risk, while examining the modifying roles of genetic predisposition and colonoscopy screening.</p><p><strong>Methods: </strong>A total of 291 177 UK Biobank participants were included in the analysis. LE8 comprises eight indicators: diet, physical activity, nicotine exposure, sleep health, body mass index, blood lipids, blood glucose, and blood pressure. Cox proportional hazards models were used for analysis.</p><p><strong>Results: </strong>During a median follow-up of 12.97 years, 3791 incident CRC cases were identified. Compared with low LE8 scores, high LE8 scores were associated with a 26% reduced CRC risk (HR: 0.74; 95% CI 0.64 to 0.86). High LE8 was linked to a 27% lower CRC risk in individuals with high genetic risk (HR: 0.73; 95% CI 0.56 to 0.94) and a 35% reduction in those without a history of colonoscopy screening (HR: 0.65; 95% CI 0.54 to 0.78). Joint analysis showed a 78% lower CRC risk in those with high LE8 and low genetic risk (HR: 0.22; 95% CI 0.15 to 0.34).</p><p><strong>Conclusion: </strong>Better CVH is associated with a reduced risk of CRC, particularly in individuals with high genetic susceptibility and those without a history of colonoscopy screening.</p>","PeriodicalId":9235,"journal":{"name":"BMJ Open Gastroenterology","volume":"13 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13007110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147479759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of an optimal pathway for endoscopic sleeve gastroplasty implementation in the NHS: a modified nominal group technique study.","authors":"Andrew Currie, Francis O'Neill, Bu Hayee, Devinder Bansi, Chetan Parmar, Emily McBride, Kevin Fernando, Laura Grimes, Arutchelvam Vijayaraman, Kamal Mahawar, Charlotte Allan, Anjan Dhar, Ken Clare, Dimitri J Pournaras, Helen M Parretti, Jamie Kelly","doi":"10.1136/bmjgast-2025-002050","DOIUrl":"10.1136/bmjgast-2025-002050","url":null,"abstract":"<p><strong>Objective: </strong>The UK faces a significant obesity crisis, and multiple management options are now available, including pharmacotherapy, endoscopic and surgical interventions. Endoscopic Sleeve Gastroplasty (ESG) has emerged as a National Institute for Health and Care Excellence-approved, minimally invasive obesity care procedure, which is a safe and effective option for selected patients. Despite its promise, National Health Service (NHS) providers lack standardised guidance for the implementation of this intervention. This initiative is aimed at creating a comprehensive pathway for the implementation of ESG within the NHS using a diverse stakeholder approach.</p><p><strong>Methods: </strong>A modified nominal group technique (NGT) was employed, bringing together a diverse group of healthcare professionals (HCPs) involved in obesity management from primary and secondary care, commissioner representatives and patient groups in an iterative consensus-building process. The NGT methodology allowed for structured discussion, prioritisation of key elements and sequential refinement of the pathway through multiple rounds of expert input and feedback.</p><p><strong>Results: </strong>The panel reached agreement on HCP requirements, resource allocation and identified key considerations for successful ESG implementation. Critical elements included primary care engagement, dietetic support, psychological assessment and anaesthetic involvement alongside the procedural aspects of training and mentoring, patient selection and technical factors. Notably, no areas of significant disagreement were identified throughout the process, enabling the development of a comprehensive framework for ESG delivery.</p><p><strong>Conclusion: </strong>This framework provides practical proposals to facilitate ESG implementation across NHS centres, supporting multidisciplinary care delivery while acknowledging operational feasibility within existing NHS resource constraints.</p>","PeriodicalId":9235,"journal":{"name":"BMJ Open Gastroenterology","volume":"13 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12993356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147455577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advanced imaging (narrow band and acetic acid chromoendoscopy) and guided biopsies in surveillance of Barrett's oesophagus: a systematic review.","authors":"Champika Gamakaranage, Thomas David Butler, Elizabeth Ratcliffe, James Britton, Richard Keld, Neeraj Prasad, Shaheen Hamdy, John McLaughlin, Yeng Ang","doi":"10.1136/bmjgast-2025-002157","DOIUrl":"10.1136/bmjgast-2025-002157","url":null,"abstract":"<p><strong>Objectives: </strong>To systematically synthesise the evidence behind the use of narrow band imaging (NBI) and acetic acid chromoendoscopy (AAC) in Barrett's oesophagus (BO) surveillance.</p><p><strong>Design: </strong>The exploration phase followed the conceptual frameworks of Arksey and O'Malley and Levac <i>et al</i> for scoping reviews, and subsequently evolved into a systematic review that followed Joanna Briggs Institute (JBI) methodological guidance for conduct and Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines for reporting.</p><p><strong>Data sources: </strong>PubMed, Medline, Scopus, Web of Science, Embase, CINHAL, Gray literature (GreyNet and OpenGrey) and reference reading.</p><p><strong>Eligibility criteria: </strong>Peer-reviewed full publications on interventional studies and cohort studies reporting effectiveness of NBI or AAC used for BO surveillance were included. Database searches were performed without restrictions on date of publication, up to the search period (December 2024-January 2025). Other observational studies, abstracts and non-English publications were excluded.</p><p><strong>Data extraction and synthesis: </strong>Data extraction and synthesis was performed by two reviewers using Covidence. The data were synthesised narratively and evaluated for quality of evidence.</p><p><strong>Results: </strong>Initial search produced 974 articles. After excluding duplicates (389), ineligible articles (526) and abstract-only publications (15), 44 articles were selected for inclusion. Results indicated that NBI-targeted biopsies are more effective in overall dysplasia detection than white light endoscopy (WLE). While NBI and AAC are both effective in BO diagnosis with a smaller number of biopsies, AAC demonstrated a higher sensitivity for neoplasia detection than WLE. However, neither NBI-guided nor AAC-guided biopsy was able to replace Seattle protocol.</p><p><strong>Conclusion: </strong>NBI provides higher dysplasia detection and AAC has a higher sensitivity, but neither can safely replace Seattle protocol biopsies.</p>","PeriodicalId":9235,"journal":{"name":"BMJ Open Gastroenterology","volume":"13 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12993361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147455538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using an integrative multi-omics and in vitro approach to investigate the role of tris(2-butoxyethyl) phosphate in promoting hepatic steatosis.","authors":"Gang Zhou, Xihan Gu, Xinyao Zhou, Shuai Chen, Hanyang Liu, Jing Wang","doi":"10.1136/bmjgast-2025-002123","DOIUrl":"10.1136/bmjgast-2025-002123","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the potential role of the environmental pollutant tris(2-butoxyethyl) phosphate (TBOEP) in the pathogenesis of metabolic dysfunction-associated steatotic liver disease (MASLD) and to elucidate its underlying molecular mechanisms.</p><p><strong>Methods: </strong>We employed an integrated multi-omics approach. First, a multidatabase strategy identified overlapping targets between TBOEP and MASLD, which were subjected to functional enrichment and protein-protein interaction (PPI) network analysis. Molecular docking was then used to predict binding affinities. Second, transcriptomic profiling (RNA sequencing (RNA-seq)) was performed on TBOEP-treated AML-12 hepatocytes to identify differentially expressed genes and pathways. Finally, key findings were validated in vitro using Oil Red O staining, triglyceride quantification and western blot analysis.</p><p><strong>Results: </strong>We identified 154 common targets between TBOEP and MASLD, with enrichment analysis pointing to pathways in non-alcoholic fatty liver disease and insulin resistance. PPI analysis highlighted ACTB, IL6, PPARG and PPARA as pivotal hub proteins. RNA-seq revealed 326 differentially expressed genes, with significant alterations in metabolic pathways. Cross-referencing pathways predicted from target genes with RNA-seq data revealed 10 pathways potentially impacted by TBOEP, emphasising its multifaceted effects on hepatocyte function. In vitro studies showed that TBOEP promotes lipid accumulation in hepatocytes by increasing PPARγ expression.</p><p><strong>Conclusion: </strong>Our study provides evidence that TBOEP acts as a potential environmental risk factor for MASLD. We demonstrate that TBOEP promotes hepatocyte steatosis, likely through the dysregulation of metabolic pathways centred on PPARγ signalling. These findings provide new insights into the pathogenesis of MASLD.</p>","PeriodicalId":9235,"journal":{"name":"BMJ Open Gastroenterology","volume":"13 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12970137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147347608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of extraintestinal manifestations and disease severity in paediatric inflammatory bowel disease: a multicentre cohort study.","authors":"Ágnes Eszter Tímár, Márk Hernádfői, Brigitta Teutsch, Zsolt Abonyi-Tóth, Nelli Farkas, Zoltán Sipos, Péter Hegyi, Anna Karoliny, Andrea Párniczky, Áron Cseh, Antal Dezsőfi, Miklós Garami, Judit Czelecz, Ildikó Guthy, Márta Kovács, Ágnes Horváth, Márta Balogh, András Tárnok, Dániel Szűcs, Orsolya Kadenczki, Éva Kosaras, Natália Lásztity, Katalin Eszter Müller","doi":"10.1136/bmjgast-2025-002130","DOIUrl":"10.1136/bmjgast-2025-002130","url":null,"abstract":"<p><strong>Objective: </strong>Extraintestinal manifestations (EIMs) are common in paediatric inflammatory bowel disease (IBD), often impairing quality of life. Our aim was to assess whether EIMs at diagnosis are associated with disease severity in paediatric IBD.</p><p><strong>Methods: </strong>We conducted a post hoc analysis from the Hungarian Pediatric IBD Registry (2010-2020), including children with Crohn's disease (CD) or ulcerative colitis (UC). Outcomes (relapse, steroid dependency, biological therapy (BT), surgery) were compared between patients with EIMs at diagnosis and those without, using Kaplan-Meier and Cox regression analyses.</p><p><strong>Results: </strong>Among 1590 patients, EIMs were more frequent in CD than in UC (25% vs 14%, p<0.0001). In CD, EIMs were linked to earlier steroid dependency (p=0.0047) and BT initiation (p=0.00049). Patients without EIMs had a higher risk of intestinal resection (HR 3.2; 95% CI 1.572 to 6.472; p=0.001). In UC, EIMs were not associated with relapse (p=0.600), steroid dependency (p=0.890) or need for BT (p=0.081). Colectomy occurred earlier in the patients with EIMs (p=0.032).</p><p><strong>Conclusion: </strong>In patients with CD, EIM at diagnosis more often required BT, but underwent fewer surgeries. In patients with UC, EIMs at diagnosis appeared to be associated with an increased risk of BT and colectomy.</p>","PeriodicalId":9235,"journal":{"name":"BMJ Open Gastroenterology","volume":"13 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12933805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147282599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating treatment to a target of transmural healing in patients with moderately to severely active Crohn's disease: rationale, design and protocol for the randomised controlled VECTORS trial.","authors":"Vipul Jairath, Sudheer K Vuyyuru, Guangyong Zou, Christopher Ma, Blue Neustifter, Christian Agboton, Itzel Romo Bautista, Mariangela Allocca, Yoon-Kyo An, Jakob Begun, Robert V Bryant, Silvio Danese, Marla Dubinsky, Brian G Feagan, Marcelo Freire, Kerri L Novak, Remo Panaccione, Aviv Pudipeddi, David T Rubin, Bruce E Sands, Miles P Sparrow, Stuart A Taylor, Krisztina B Gecse, Rune Wilkens, Christian Maaser","doi":"10.1136/bmjgast-2025-002088","DOIUrl":"10.1136/bmjgast-2025-002088","url":null,"abstract":"<p><strong>Introduction: </strong>The optimal treatment target for Crohn's disease (CD) is unknown. Targeting transmural healing (TMH) may be associated with a lower risk of complications than clinical and endoscopic outcomes. The Study to Evaluate Transmural Healing as a Treatment Target in Crohn's Disease (VECTORS) aims to investigate TMH as a potential treatment target and its long-term benefits in patients with CD.</p><p><strong>Methods and analysis: </strong>VECTORS is a phase 4, interventional, parallel-group, multicentre, randomised controlled trial. Approximately 304 adult patients with moderately to severely active CD from multiple international sites will be enrolled and randomly assigned in a 1:1 ratio to treatment target group 1 (corticosteroid-free intestinal ultrasound-based response or TMH plus clinical and biomarker remission) or group 2 (corticosteroid-free clinical and biomarker remission). All patients receive vedolizumab according to the standard dosing regimen, with an additional dose at week 10, followed by a treatment escalation algorithm to reach the assigned targets. Randomisation will be stratified by prior advanced therapy exposure, disease location and disease duration. The primary objective is to determine if treatment target group 1 is superior to group 2 for the primary efficacy outcome of corticosteroid-free endoscopic remission at week 48. CD-related complications (key secondary outcome) are assessed at week 96.</p><p><strong>Ethics and dissemination: </strong>The trial is conducted in compliance with the protocol and applicable regulatory requirements and is approved by institutional review boards/independent ethics committees at the country or site level. Patients' written informed consents are obtained and documented prior to trial participation. Findings will be disseminated in peer-reviewed journals and at scientific congresses.</p><p><strong>Trial registration numbers: </strong>NCT06257706; EUCT, 2023-509096-16-00.</p>","PeriodicalId":9235,"journal":{"name":"BMJ Open Gastroenterology","volume":"13 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12927283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146257678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of transmural treatment response in known Crohn's disease: a prospective blinded study of the intermodality agreement between intestinal ultrasound and magnetic resonance enterography.","authors":"Jacob Broder Brodersen, Søren Rafael Rafaelsen, Emilia Nejatbakhsh, Michael Dam Jensen","doi":"10.1136/bmjgast-2025-002175","DOIUrl":"10.1136/bmjgast-2025-002175","url":null,"abstract":"<p><strong>Objective: </strong>Intestinal ultrasound (IUS) and magnetic resonance enterography (MRE) are state-of-the-art modalities recommended for monitoring Crohn's disease (CD) activity and treatment response. This study aimed to examine the intermodality agreement for determining transmural response to medical treatment.</p><p><strong>Methods: </strong>IUS and MRE performed in a prospective, blinded, multicentre study were included in the analysis. Patients with endoscopically active CD completed IUS and MRE before and after medical treatment. Observers were blind to the result of the other modality. Findings and disease classification at baseline, as well as the intermodality agreement for transmural treatment response, were determined.</p><p><strong>Results: </strong>35 patients entered the analysis. IUS and MRE detected 59 (24.1%) and 42 (17.1%) segments with active CD at baseline, respectively (p=0.001). Disease location and behaviour were determined with a moderate intermodality agreement (κ=0.48 and κ=0.43, p<0.01). Global IUS and MRE activity scores decreased after medical treatment (p<0.05), and repeated measurement correlations were weak to moderate. The intermodality agreement for transmural treatment response was fair to moderate: IUS versus Magnetic Resonance Index of Activity κ=0.43 (95% CI 0.13 to 0.73, p=0.006) and IUS versus Clermont score κ=0.31 (95% CI 0.01 to 0.60, p=0.026). Normalisation of bowel wall thickness occurred in 12 (34.3%) patients with MRE and 11 (31.4%) patients with IUS. The intermodality agreement was moderate (κ=0.42, 95% CI 0.10 to 0.74, p=0.007).</p><p><strong>Conclusion: </strong>Transmural response and healing are determined with considerable variability. Maintaining consistency in imaging modality between assessments is essential to ensure an accurate interpretation.</p><p><strong>Trial registration number: </strong>NCT03435016.</p>","PeriodicalId":9235,"journal":{"name":"BMJ Open Gastroenterology","volume":"13 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12887502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146149220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between patient characteristics and completeness of colon capsule endoscopy in colorectal cancer screening participants: a cross-sectional study.","authors":"Lea Østergaard Hansen, Thomas Bjørsum-Meyer, Ola Selnes, Lasse Kaalby Møller, Benedicte Schelde-Olesen, Anastasios Koulaouzidis, Gunnar Baatrup, Ulrik Deding","doi":"10.1136/bmjgast-2025-001981","DOIUrl":"10.1136/bmjgast-2025-001981","url":null,"abstract":"<p><strong>Objective: </strong>Incomplete investigations challenge the clinical use of colon capsule endoscopy (CCE). This results in added cost to healthcare systems and added discomfort to patients. In order to potentially lower the re-investigation rate, we aimed to investigate the association between multiple patient characteristics and complete CCE.</p><p><strong>Methods: </strong>In 2020, the CareForColon2015 (CFC2015) Trial was initiated in the Region of Southern Denmark, investigating the performance of CCE in colorectal cancer screening. Data from the CFC2015 Trial were combined with data from multiple national registers. Completion rates were calculated and their relation to the different patient characteristics was analysed in univariate and multivariate logistic regression models.</p><p><strong>Results: </strong>We analysed 1472 participants, of whom 1016 (69.1%) had complete investigations. We investigated the associations between 17 patient characteristics and complete CCE investigation. The multivariate analysis showed that smokers and heavy drinkers had a higher probability of a complete investigation, with ORs of 1.69 (95% CI 1.12 to 2.55) and 2.72 (95% CI 1.52 to 4.87), respectively, compared with non-consumers. We also found that increasing income was associated with increased odds of CCE completion (OR 1.78, 95% CI 1.30 to 2.43, for the highest quartile). High body mass index (>40) and self-reported constipation or laxative use were significantly associated with incomplete CCE, with ORs of 0.40 (95% CI 0.17 to 0.97) and 0.65 (95% CI 0.47 to 0.90), respectively.</p><p><strong>Conclusion: </strong>This study tested multiple factors for association with CCE completion. The results indicate that some factors are associated with higher odds of completion, while others are associated with lower odds of completion. These results confirm that specific patient characteristics correlate with the odds of complete investigation. This can, in turn, be used to determine the individual diagnostic pathway. Additional studies are needed for less frequently reported characteristics and to further support these findings.</p>","PeriodicalId":9235,"journal":{"name":"BMJ Open Gastroenterology","volume":"13 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12887524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146131239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research engagement and patient-reported quality of care: a cross-sectional study of UK inflammatory bowel disease services.","authors":"Robert J Mulligan, Pat Ryan, Lauren C Beck, Paul Christiansen, Jessica Turner, Christian P Selinger, J R Fraser Cummings, Matthew J Brookes, A Barney Hawthorne, Christopher A Lamb","doi":"10.1136/bmjgast-2025-002122","DOIUrl":"10.1136/bmjgast-2025-002122","url":null,"abstract":"<p><strong>Objective: </strong>Across several clinical specialties, research-active hospitals deliver higher-quality care and achieve better patient outcomes. To date, these associations have primarily been demonstrated using hospital-reported metrics, with limited insight from the patient perspective. This study evaluated, for the first time, the association between research activity within UK inflammatory bowel disease (IBD) hospital services and adult patient-reported quality of care.</p><p><strong>Methods: </strong>A cross-sectional analysis was conducted using 2023 national IBD UK benchmarking Patient and Service Survey data linked with research recruitment metrics from the National Institute for Health and Care Research Central Portfolio Management System (CPMS) between 2020 and 2022. Patient-reported high-quality care in the preceding 12 months was defined as a response of 'good', 'very good' or 'excellent' on a five-point Likert scale. Research activity was measured by the number of participants recruited to CPMS-registered IBD studies managed by gastroenterology. Associations were assessed using Spearman's correlation and multivariate regression, adjusting for service-level factors.</p><p><strong>Results: </strong>Recruitment data from 32 391 research participants across 176 IBD services were aligned with 11 454 care quality and 13 583 research opportunity patient responses. A positive correlation was observed between IBD service research recruitment volume and the proportion of patients reporting high-quality care (rₛ=0.19, p=0.013). This association remained significant after adjusting for tertiary status, service size, number of consultants and presence of an IBD leadership team (adjusted β (SE)=0.0008 (0.0004); p=0.029). Services recruiting to interventional studies demonstrated higher patient-reported care quality, while those offering research opportunities reported both higher care quality and greater research recruitment.</p><p><strong>Conclusion: </strong>IBD service research activity is positively associated with patient-reported care quality. Embedding research engagement within routine service delivery may improve patient experience and support quality improvement. The results have important implications for service design, workforce planning and national research policy.</p>","PeriodicalId":9235,"journal":{"name":"BMJ Open Gastroenterology","volume":"13 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12853465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146040416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative efficacy, safety and compliance with dual, triple and quadruple therapy as the first-line treatment regimens for <i>Helicobacter pylori</i> eradication: a systematic review and network meta-analysis.","authors":"Iqbal Taufiqqurrachman, Ari Fahrial Syam, Hasan Maulahela, Murdani Abdullah, Takashi Matsumoto, Muhammad Miftahussurur, Yoshio Yamaoka","doi":"10.1136/bmjgast-2025-002037","DOIUrl":"10.1136/bmjgast-2025-002037","url":null,"abstract":"<p><strong>Objective: </strong>To assess the efficacy, safety and compliance with dual, triple and quadruple therapy first-line regimens for <i>Helicobacter pylori</i> eradication.</p><p><strong>Design: </strong>A systematic review and network meta-analysis (NMA) reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses NMA guidance.</p><p><strong>Data sources: </strong>PubMed, Cochrane Library, ProQuest and Scopus were searched until 12 October 2025.</p><p><strong>Eligibility criteria: </strong>Randomised controlled trials (RCTs) published in English that measured the eradication rate, adverse events and compliance rates of dual therapy compared with triple or quadruple therapy for <i>H. pylori</i> first-line treatment.</p><p><strong>Data extraction and synthesis: </strong>Data extraction and risk-of-bias assessment were performed by two independent reviewers. The data were analysed and represented as pooled ORs. Heterogeneity was assessed using meta-regression and trim-and-fill analyses.</p><p><strong>Results: </strong>Pairwise meta-analysis of 56 RCTs showed that dual therapy had no different eradication rates than triple therapy (intention-to-treat (ITT): OR 0.88, 95% CI 0.60 to 1.29; per-protocol (PP): OR 0.76, 95% CI 0.46 to 1.25). Dual therapy outperformed quadruple therapy (OR 1.20, 95% CI 1.04 to 1.39) with fewer adverse events (OR 0.32, 95% CI 0.28 to 0.38) and higher compliance rates (OR: 1.49, 95% CI 1.26 to 1.76). Based on the NMA, RAC-7 has the highest probability of effective treatment for both ITT (P-score=0.9436) and PP (P-score=0.9545).</p><p><strong>Conclusion: </strong>Dual therapy represents a promising first-line option, demonstrating comparable efficacy and adverse event rates with higher compliance, although triple therapy showed the highest probability of being the most effective first-line regimen in the NMA, followed by quadruple therapy. Further studies in non-Asian populations, along with resistance-guided treatment approaches, are needed to refine global eradication strategies.</p>","PeriodicalId":9235,"journal":{"name":"BMJ Open Gastroenterology","volume":"13 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12815173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145984483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}