OMED Guidelines & Consensus Statements
Ethical implications relating to Live Endoscopy Demonstrations
Live demonstrations are traditional and popular methods of teaching practical digestive endoscopy. They enable the attendees to observe and interact with experts who are making decisions without hindsight in the same manner as in normal endoscopic practice. Unexpected findings and practical difficulties encountered are addressed and overcome emphasizing the importance of keeping calm and adopting a methodical approach when under pressure. Never-the-less criticisms have been expressed that patients may be disadvantaged by agreeing to examination by a visiting specialist perhaps using unfamiliar equipment and in circumstances where the normal clinical lines of responsibility may be impaired. The endoscopic community therefore has a moral and legal responsibility to ensure that each patient's welfare is protected.
The World Organization of Digestive Endoscopy (OMED) is strongly in favour of teaching by live demonstration but believes that the safety and dignity of the patient is paramount. For this reason we have reviewed, condensed and updated the ethical advice that was published by the European Society of Gastrointestinal Endoscopy in 2003. We set out here an ethical standard for the performance of live demonstrations that was approved by the OMED Centers of Excellence and the OMED Governing Council in November 2009.
» View OMED Guideline on ethical implications relating to Live Endoscopy Demonstrations here (PDF file 
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The London OMED position statement for credentialing and quality assurance in digestive endoscopy
OMED, the World Organisation of Digestive Endoscopy, convened a working party to develop guidelines to help healthcare institutions in ensuring high quality endoscopic care. Chaired by Dr. Douglas Faigel and Dr. Peter Cotton, the working party of interested endoscopists from around the world sought to create international standards for credentialing and quality assurance. The resultant London OMED position statement was presented to the World Congress of Gastroenterology in London, on 25 November 2009, and published in the Journal Endoscopy in December, 2009. The position statement provides guidance on granting and renewal of privileges, determination of competency, and quality assurance and improvement including measurement of quality indicators. This position statement will be useful to healthcare institutions and endoscopy units, wherever in the world digestive endoscopy is performed, to assist them in establishing quality assurance programs to improve the healthcare services they provide.
» View OMED position statement here (PDF file )
Role of small-bowel endoscopy in the management of patients with inflammatory bowel disease: an international OMED-ECCO consensus
A. Bourreille et al. 2009; Endoscopy 41: 618-637
Capsule endoscopy enables the whole of the small bowel mucosa to be examined visually where previously its appearance could be inferred only from the black and white contours of contrast radiology. Its rapid acceptance however soon highlighted the frustrating deficiencies inherent in visualization without biopsy or therapy. Balloon and spiral assisted enteroscopy have overcome this but the question does arise as to how and when small bowel endoscopy should be employed.
These new techniques are particularly valuable in the management of IBD but the indications for their use are complex. OMED therefore has cooperated with the European Colitis and Crohns Organization (ECCO) to write a consensus statement which is now published in Endoscopy and there is a direct link to it from our web site below.
OMED are grateful to the working party for their time and expertise and in particular we thank the steering group that was ultimately responsible for it. They were Arnaud Boureille, Ana Ignjatovic, Simon Travis, Jean-Frédéric Colombel and Andre Van Gossum.
» View article here (PDF file )
OMED, in collaboration with the World Gastroenterology Organisation (WGO), has developed a unique guideline on Endoscope Disinfection which provides optional methods of disinfection to meet the varying level of resources in different regions of the world. This guideline can be downloaded as shown below.
Introduction to the OMED/WGO Practice Guideline: Endoscope Disinfection (Douglas Nelson)
It goes without saying that endoscopy is an integral part of modern gastroenterology, and the enormous benefits of this technology have been well established. However, the importance of appropriate endoscope reprocessing is probably taken for granted by most practitioners. Large, comprehensive reviews of transmission of infection during endoscopy have demonstrated that when currently accepted reprocessing practices are followed (in the absence of faulty equipment), there have been no reported episodes of transmission of infection. A recent study of over 8,000 patients undergoing endoscopy that underwent pre- and post-procedure serology for hepatitis C virus in an endemic area found no episodes of HCV seroconversion, which should put to rest the notion that we are missing occult infections. This admirable safety record should not be a cause for complacency. We know that compliance with various reprocessing guidelines is not uniform, which highlights the importance of the following OMED/WGO guideline for endoscope disinfection. The strength of the document lies not in profound new insights into infection control (although it does an excellent job summarizing recent developments in the field), or radically new recommendations. In fact, the emphasis on mechanical cleaning of the endoscope as the most critical step in endoscope reprocessing brings us full circle to the origins of endoscope reprocessing, when this was often the only step performed. The fundamental importance of this document is that it represents a truly international consensus of over 150 gastroenterology and digestive endoscopy societies around the world, committed to a simple, uniform, and comprehensive standard to maximize compliance. A particularly novel aspect of the present guideline is the "cascade" concept, which attempts to reconcile a "gold standard" for endoscope reprocessing with a "minimum standard" for areas with more limited local resources. As medical societies struggle with making guidelines more global in scope, OMED/WGO has addressed this challenge with a thoughtful approach to endoscope reprocessing.
» View and download WGO Practice Guideline: Endoscope Disinfection (PDF file, size 248kB )
» Japanese language version of WGO Practice Guideline: Endoscope Disinfection (PDF file, size 315kB )
Different language versions of this guideline together with accompanying annotated evidence is available via the World Gastroenterology Organisation website:
View and download further WGO/OMED Guidelines here