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A Modern Approach to Design.
Epsilon is a modern, sectioned based design, with a diverse infusion of background textures and patterns. These enrich and differentiate your site whilst maintaining an overall conservative approach, for flexible site application.
Background SlideshowEpsilon provides for full width, custom, transitional background images, in the slideshow position, a full width container, specifically designed for RokSprocket's Features layout. It also has separate options for per panel background and content images. Read More
A Modern Approach to Design.Epsilon is a modern, sectioned based design, with a diverse infusion of background textures and patterns. These enrich and differentiate your site whilst maintaining an overall conservative approach, for flexible site application. Read More
Acute Complicated Diverticulitis
Acute complicated diverticulitis (ACD) is a common surgical emergency with significant implications for patients like major surgical intervention, intensive care support and life-long stoma. However, there is currently no standardization of care or unified national guidelines. The NICE guidelines stop short at when to refer patients to hospital.
Although there are numerous studies published relating to several management aspects of diverticulitis, none present good level 1 evidence. As a result, surgical units often adopt variable policies.
There is a strong need to design good randomized controlled studies addressing various issues in ACD but for these to be of a sufficiently high quality it is essential to define the current scale of the problem and variability in management trends.
The National Complicated Acute DiverticulitiS (CADS) project aims to obtain real life data from patients suffering from acute diverticulitis within the UK. This will provide a pragmatic insight into the issues surrounding management and related outcomes as well be a relevant source of data to inform future trial designs and subsequently clinical guidelines.
It is expected to be delivered in three components:
1) The National CADS Audit:
This national audit aims explore the impact of variability in management approach on short term patient outcomes. It will also provide landmark data on the national incidence, management strategies, short-term (3 months) and long-term (2 years) patient outcomes, stoma rates and the role of surgical and radiological intervention. This was planned to be delivered in 3 phases (Phase 1: initial recruitment from July to September 2014; Phase 2: 3 month follow-up; Phase 3: 2 year follow-up)
2) CADS prospective studies/trials:
As mentioned above, data from the CADS audit will be analysed to identify real issues surrounding the care of patients with acute diverticulitis. These would be developed into research questions and study designs/power calculations will be informed by the CADS audit data set.
3) Developing Clinical Guidelines:
It is anticipated that evidence generated by the above process will generate robust Level 1 evidence to inform clinical guidelines
The National CADS audit witnessed an unprecedented interest in this subject area nationally with 107 centres originally recruited and more than 250 collaborators. A dataset of nearly 2500 patients with clinically suspected acute diverticulitis has been generated. Phases 1 and 2 of the National CADS audit have been successfully delivered so far. Phase 3 is anticipated to be rolled out on the 1st of October 2016. Further details with databses will be emailed to individual centres in due course.
DDF 2015 invited talk
The CADS audit team were honoured to have received the privilege to present interim results at the Digestive Diseases Federation Meeting at London in June 2015. This is a good example of how surgeons nationally could collaborate and deliver high quality work. We hope to move from success to success with this project.
The CADS protocol has been submitted for publication to BMJ open gastroenterology and has received encouraging reviewer comments. It is anticipated that the manuscript will be accepted for publication pending submission of requested details.
Further manuscripts are currently in draft stage to be submitted shortly.