Thanks to those that made the meeting today. For those that couldn’t attend please email me any comments, ideas or suggestions any time. There were three main areas of discussion:
1. Guideline and dissemination:
a. The guideline produced by this group is now available on the BSPR website
b. Following this meeting I shall ask for previous documents from meetings and the current audit report form to be uploaded so that they are more widely available and accessible
c. The guideline content dates from 2017/8 so could do with a quick refresh already
i. Fiona Dickinson has kindly agreed to do this but another one or two to screen abstracts would cut down the time (there are ~3-400 on a quick PubMed search for “intuss*” AllChild)
ii. There has been interest in publishing this more formally as a group publication which is possible once this is done and it has been round for comments. Not essential but makes it even more accessible.
2. Running of the group/audit
a. I’m happy to keep doing what I’ve been doing but if anyone is interested in taking a more active role please let me know, would be good to have more eyes and minds on tasks and problem solving
b. At present there is no other easy home for the audit. I have defaulted to the audit form being in Excel as it is more widely familiar and won’t scare any IT departments but it is far from ideal
c. Unless there are any other thoughts I still favour a locally held individual common format registry that can be shared if desired to a more centralised model. Buy in and engagement are more important as they are the usual points of failure for such projects.
d. If submissions and engagement continue to grow eventually I hope we can find a more permanent and robust solution despite not being able to do so yet.
3. Audit
a. About 10 centres (nearly 50%) have sent some data at some point which is fantastic and I know there are others who have probably got theirs. Existing and pandemic pressures are making things even busier than usual though.
i. These are sufficient to share in anonymised form which I think would be useful to everyone for comparison and hopefully encouragement as well as discussion
ii. If there are no objections, the BSPR website member area seems the best compromise and appended below is my suggested inclusion
b. I am sending them all submitting centres a copy of their data on the current audit form with comments on any anomalies or possible errors to check at source
c. Prospective registration of cases remains challenging but should be the ultimate goal as retrospective identification is laborious due to relative rarity, coding and database limitations
Best wishes to everybody
Basil

Audit specific feedback
1. If you have a zero primary surgery rate (no attempted enema) it is likely cases managed with minimal/zero radiology involvement have been missed by your search strategy (see previous suggestions for case identification). Local surgical teams may be able to help if they have done their own audits or are more familiar with the other clinical information systems in your trust
2. The new audit form will identify (and count) duplicate patients to help consistency with handling of repeat enemas and episodes (see previous recommendations)
3. If you do not include patient gender the current charts don’t count cases, relatively easy to request from clinical governance/information departments with a list of hospital numbers. Gender ratios are another soft check of completeness of case identification
4. I have not deleted any fields but have made some amendments and identified these through comments on the audit form. Some rows could be deleted or otherwise are archived (excluded) from the calculations and data presentation
5. Smaller centres and low volume years will naturally have wider swings in the reported outcomes but these can be put into better context with longer series averages and will always be challenging to interpret

Suggested presentation for sharing on BSPR website: Graph 1 Graph 2

Average Reduction Rate = 82%

Any other comments, queries or suggestions please email me directly and send any anonymised updated data as it becomes available
[email protected]