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Your search keyword '"Richard L. Hooper"' showing total 2 results
Start Over Author "Richard L. Hooper" Topic medicine
2 results on '"Richard L. Hooper"'

1. ESCP Safe Anastomosis ProGramme in CoLorectal SurgEry (EAGLE): Study protocol for an international cluster randomised trial of a quality improvement intervention to reduce anastomotic leak following right colectomy

Author

António Sampaio Soares, Tatiana, Garmanova, Gianpiero, Gravante, Edward, Bywater, Michala, Pettitt, Mary, L Venn, James, C Glasbey, Dmitri, Nepogodiev, Elizabeth, Li, Ana, Minaya-Bravo, Ionut, Negoi, Matteo, Frasson, Richard, L Hooper, Charles, H Knowles, Dion Gregory Morton, Aneel, Bhangu, Brett, E Dawson, James, Keatley, Laura, Magill, Rita, Perry, Thomas, Pinkney, Mark, A Potter, Jonathan, P Evans, Sivesh, Kamarajah, Siobhan, C McKay, Daniel, Osei-Bordom, Sanjay, Chaudhri, Luis, Sánchez-Guillén, Jasper, Stijns, Yu Ting Van Loon, Dieter, Hahnloser, David D, E Zimmerman, Nicolas, C Buchs, Liam, Cato, Miguel, Cunha, Charlotte, El-Sayed, David, Finch, Gallo, G, Ruben, Martins, Peter Mark Neary, Pata, Francesco, Tomas, Poskus, April, C Roslani, Elgun, Samadov, Mohammed, Sbaih, Mostafa, Shalaby, Joana, Simões, Aaditya Prakash Sinha, Emre, Sivrikoz, Armen, Vardanyan, Antonino, Spinelli, David, J Beard, Marion, Campbell, Omar, Omar, Aaditya, Sinha, and Surgery

Subjects
Relative risk reduction, dog-leg cluster randomised, medicine.medical_specialty, Colectomies, Leak, Anastomotic Leak, Anastomosis, Dogs, medicine, Animals, Humans, Colectomy, Randomized Controlled Trials as Topic, business.industry, General surgery, Anastomosis, Surgical, Gastroenterology, Absolute risk reduction, randomised trial, Quality Improvement, Colorectal surgery, Cohort, Right Colectomy, quality improvement study, business, anastomotic leak, colorectal surgery, right hemicolectomy, Colorectal Surgery
Abstract

Aim Cohort data suggest that anastomotic leak occurs after 8% of right colectomies causing significant morbidity and mortality. Patient selection, intra-operative factors, and technical variation all contribute to risk of leak. The EAGLE study will assess whether implementation of the European Society of Coloproctology (ESCP) Safe Anastomosis Intervention reduces anastomotic leak following right colectomy. Methods An international, multi-centre, cluster randomised trial will be undertaken with hospitals as clusters. Hospitals will be recruited in a number of distinct phases, with each phase following the same research plan, in which clusters are randomised to one of three, staggered (dog-leg) schedules for implementation of the Safe Anastomosis Intervention. Results Results from different phases will be meta-analysed. The intervention is a three-component behavioural change programme for surgeons, anaesthetists and operating room staff, supported by an online learning environment. All colorectal surgical units around the world will be eligible. Adults undergoing elective or emergency right colectomy or ileocaecal resection, by any approach and for any indication will be included. The primary outcome is 30-day anastomotic leak rate, defined as clinical or radiologically-detected leak or intra-abdominal or pelvic collection. Assuming hospitals provide data for an average of 10 patients per two month recruitment period, 333 clusters (4440 patients in total) will allow for detection of an absolute risk reduction of anastomotic leak from 8.1% to 5.6% (relative risk reduction 30%). This protocol adheres to Standard Protocol Items: Recommendations for Intervention Trials (SPIRIT). Discussion The protocol describes the methods for an evaluation of a hospital-level, education-based quality improvement intervention targeted to reduce the life-threatening surgical complication of anastomotic leak.

Published
2021

2. Systematic review of preoperative and intraoperative colorectal Anastomotic Leak Prediction Scores (ALPS)

Author

Charles H Knowles, Richard L Hooper, Dmitri Nepogodiev, Tom Pampiglione, Mary L Venn, and Dion G Morton

Subjects
Medicine
Abstract

Objective To systematically review preoperative and intraoperative Anastomotic Leak Prediction Scores (ALPS) and validation studies to evaluate performance and utility in surgical decision-making. Anastomotic leak (AL) is the most feared complication of colorectal surgery. Individualised leak risk could guide anastomosis and/or diverting stoma.Methods Systematic search of Ovid MEDLINE and Embase databases, 30 October 2020, identified existing ALPS and validation studies. All records including >1 risk factor, used to develop new, or to validate existing models for preoperative or intraoperative use to predict colorectal AL, were selected. Data extraction followed CHecklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies guidelines. Models were assessed for applicability for surgical decision-making and risk of bias using Prediction model Risk Of Bias ASsessment Tool.Results 34 studies were identified containing 31 individual ALPS (12 colonic/colorectal, 19 rectal) and 6 papers with validation studies only. Development dataset patient populations were heterogeneous in terms of numbers, indication for surgery, urgency and stoma inclusion. Heterogeneity precluded meta-analysis. Definitions and timeframe for AL were available in only 22 and 11 ALPS, respectively. 26/31 studies used some form of multivariable logistic regression in their modelling. Models included 3–33 individual predictors. 27/31 studies reported model discrimination performance but just 18/31 reported calibration. 15/31 ALPS were reported with external validation, 9/31 with internal validation alone and 4 published without any validation. 27/31 ALPS and every validation study were scored high risk of bias in model analysis.Conclusions Poor reporting practices and methodological shortcomings limit wider adoption of published ALPS. Several models appear to perform well in discriminating patients at highest AL risk but all raise concerns over risk of bias, and nearly all over wider applicability. Large-scale, precisely reported external validation studies are required.PROSPERO registration number CRD42020164804.

Published
2023
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