Author: Jason Curtis

Intra-network Variation in Neoadjuvant Therapy Delivery for Borderline Resectable and Locally Advanced Pancreatic Cancer: Time to Centrally Coordinate Oncology Pathways? (2026)

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Type of publication:

Conference abstract

Author(s):

Labib P.L.Z.; Alarabiyat M.; Powell-Brett S.; Hall L.; Rehman S.; Edwards D.; Ma Y.T.; Sivakumar S.; Good J.; Candish C.; Nagy A.; Hafeez T.; Kunene V.; *Chatterjee A.; Roberts K.J.; Chatzizacharias N.

Citation:

HPB. Conference: 17th World Congress of the International Hepato-Pancreato-Biliary Association. Singapore Singapore. 28(Supplement 2) (pp S746), 2026. Date of Publication: 01 Jan 2026.

Abstract:

Introduction: Pancreatic cancer (PC) treatment in the UK is coordinated via regional referral networks, but formal neoadjuvant chemotherapy (NAC) pathways for borderline resectable and locally advanced PC (BR/LAPC) are rare. This retrospective cohort study assessed intra-network variation in access to diagnostics, time to treatment, and patient outcomes following NAC for BR/LAPC in our network.
Method(s): All patients with BR/LAPC referred from regional network hospitals between 2017-2021 were reviewed. Data were collected on time from first diagnostic CT to endoscopy, commencement of NAC, NAC regimens administered and patient outcomes.
Result(s): In the 155 referred patients who commenced NAC, there were significant differences in median time from diagnosis to biliary drainage (p=0.008) and endoscopic ultrasound (p=0.017). Time from diagnosis to first administration of NAC was long (median 64 days; p=0.079). There were significant differences in the proportion of patients commenced on mFOLFIRINOX (0-100%, p< 0.001) and the proportion completing NAC (0-100%, p=0.012). Despite variations in use of mFOLFIRINOX and the proportion of patients completing the planned course of NAC, this did not translate into a significant difference in the likelihood of proceeding to surgical resection between centres. Size of the referral hospital and delays to completing diagnostics and commencing NAC were not associated with a reduced chance of undergoing resection (all >0.050).
Conclusion(s): There is significant intra-network variation in access to interventional endoscopy and choice of NAC regimen. Centralised tracking of patients, development of locally agreed treatment protocols and an update to national guidelines are needed to standardise NAC pathways for BR/LAPC. * Oral Poster & Electronic Poster presented.

DOI: 10.1016/j.hpb.2026.08.1098

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Is digital documentation always best? (2026)

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Type of publication:

Journal article

Author(s):

Rai T.; *Millward H.; *Siddall K.; Riddell N.S.; *Elsmore A.; Dhadda A.; *Willson S.; Collis R.; *Parry-Smith W.; Collins P.; Hinton L.; Bell S.

Citation:

International Journal of Gynecology and Obstetrics. 175(2) (pp 1043-1044), 2026. Date of Publication: 01 Nov 2026.

DOI: 10.1002/ijgo.71079

Link to full-text [open access - no password required]

The British Society for Rheumatology specialty certificate examination question bank- a useful tool for exam revision (2026)

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Type of publication:

Conference abstract

Author(s):

Zollinger-Read C.A.; Benson R.; Watson P.A.; Coulson L.; Wincup C.; Gall S.; Rigler K.; Gregory W.J.; Man Y.; Malik M.; *Jayasekera H.S.; Elliott A.; Lemon J.; Little J.

Citation:

Rheumatology. Conference: British Society for Rheumatology Annual Conference 2026. Glasgow United Kingdom. 65(Supplement 2) (pp ii132), 2026. Article Number: keag121.257. Date of Publication: 01 Apr 2026.

Abstract:

Background/Aims: In the UK, rheumatology speciality trainees are required to pass the Specialty Certificate Examination (SCE) in order to complete training. An annual exam means it is a high stakes assessment. Practice questions have a key role in preparation, both identifying areas of weakness and familiarising candidates with the format. In 2024, the British Society for Rheumatology (BSR) launched a SCE question bank developed by the BSR's digital learning board (DLB).
Method(s): DLB members received training in writing single best answer questions. This was delivered via a teaching session and eLearning module. A robust peer review process ensures question quality control. Our question bank provides detailed answer explanations to improve understanding in weak areas and links to relevant resources e. g. BSR guidelines, podcasts, and webinars. Topic areas encompass the Joint Royal Colleges of Physicians Training Board (JRCPTB) Rheumatology 2022 curriculum, and topic weighting is based on the SCE exam blueprint (available on the RCP website). The BSR question bank is on our digital learning site and is free to members. It launched in October 2024. There are 124 questions and ever increasing. Users can work their way through the question bank or undertake quizzes. There are three general quizzes with a selection of 10, 20 or 40 questions and three quizzes on specific disease areas.
Result(s): Since launching, 175 people have accessed the question bank. The 10-question quiz is the most popular quiz, taken 2,415 times by 136 users, followed by the 40-question quiz, taken 1,785 times by 85 users. 97% of people reported that they were accessing the question bank for SCE revision. The average score on how useful the resources was 4.2/5 (1 being not useful and 5 being extremely useful). 11 users commented that they wanted more questions. See the table below for feedback from users.
Conclusion(s): The BSR eLearning SCE questions bank has been well utilised and highly rated by users. Planned question expansion will include more paediatric focussed questions, imaging, and wider coverage of topics. Please get in touch if you would like to help - writing questions is a great way to improve your knowledge! (Table presented).

DOI: 10.1093/rheumatology/keag121.257

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Prior CABG and native-vessel CTO PCI: lesion complexity, strategy planning, procedural burden, and technical success in a multicenter registry (2026)

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Type of publication:

Journal article

Author(s):

Ozturk S.; Gurbuz A.S.; Sural S.; *Goktekin S.; Gorgulu S..

Citation:

BMC Cardiovascular Disorders. 26(1) (no pagination), 2026. Article Number: 975. Date of Publication: 01 Dec 2026.

Abstract:

Background: Prior coronary artery bypass grafting (CABG) has been associated with greater lesion complexity and lower success rates in chronic total occlusion (CTO) percutaneous coronary intervention (PCI). In native-vessel CTO PCI, prior CABG may also indicate greater preprocedural complexity and more advanced strategy planning. We examined whether prior CABG was associated with lesion complexity, strategy selection, procedural burden, and technical success in a contemporary multicenter registry.
Method(s): We performed a retrospective analysis of a prospective multicenter CTO PCI registry including 1,800 consecutive native-vessel procedures performed between January 2020 and June 2025. Of these, 205 were performed in patients with prior CABG and 1,595 in patients without prior CABG. The primary endpoint was technical success, defined as final TIMI 3 flow with residual stenosis < 30%. The key secondary endpoint was procedural success, defined as technical success without in-hospital major adverse cardiac and cerebrovascular events.
Result(s): Prior-CABG procedures had greater lesion complexity, more frequent planned retrograde/hybrid crossing, longer procedural and fluoroscopy times, higher dose-area product, and greater adjusted contrast use. Technical success was lower in prior-CABG procedures (85.9% vs. 93.3%, p < 0.001), as was procedural success (84.9% vs. 92.4%, p < 0.001). In multivariable analysis, prior CABG was independently associated with technical failure (adjusted OR, 1.94; 95% CI, 1.19-3.18; p = 0.008). Planned retrograde/hybrid strategy was also associated with technical failure (adjusted OR 2.82, 95% CI 1.81-4.40, p < 0.001), a finding interpreted as reflecting case selection and lesion difficulty rather than a causal effect of the strategy. In a companion model, prior CABG was independently associated with the selection of a planned retrograde/hybrid strategy (adjusted OR 2.03, 95% CI 1.40-2.96, p < 0.001).
Conclusion(s): In native-vessel CTO PCI, prior CABG was associated with more complex lesions, more frequent retrograde/hybrid planning, greater procedural burden, and lower technical success. However, its incremental prognostic value beyond the J-CTO score was limited. Prior CABG should therefore be interpreted primarily as a marker of an unfavorable procedural phenotype rather than as a standalone risk-stratification tool.

DOI: 10.1186/s12872-026-06355-x

Link to full-text [open access - no password required]

Contradictory guidance, divided practice: a national survey of the compression screw in dynamic hip screw fixation (2026)

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Type of publication:

Journal article

Author(s):

Mohammed, Ghulam Dastagir Faisal; *Odedara, Ayodele; Khan, Muhammad Murtaza; Amin, Jebran; Saeed, Abu Zer; Younis, Zubair; Manoharan, Gopikanthan.

Citation:

Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh & Ireland. 2026 Oct 10. [epub ahead of print]

Abstract:

BACKGROUND: The compression screw is an optional ancillary component of the dynamic hip screw construct. Guidance on whether to use it, and whether to retain or remove it, is contradictory between the AO, the manufacturers and the biomechanical literature, and no clinical study has compared the two. The aim was to establish current UK practice, understanding and training.

METHODS: A ten-question electronic survey was distributed through Training Programme Directors in all 23 United Kingdom deaneries and through trainee networks, open from 20 April to 19 July 2025. Users were defined from the direct question on frequency of use. Proportions are reported with Wilson 95% confidence intervals and compared using Fisher's exact test. Free text was coded thematically.

RESULTS: One hundred responded: 42 junior and 41 senior trainees, 17 consultants. Seventy-four per cent (95% CI 65-82) use the compression screw at least occasionally. Of these, 38 (51%) remove it, 22 (30%) leave it in and 14 (19%) decide case by case, without difference by grade (p=0.43). Ninety identified on-table compression correctly, yet 40% endorsed the belief that a retained screw prevents further compression on mobilisation. Thirty-seven per cent had no teaching; teaching predicted use (p=0.0008), not understanding (p=0.61).

CONCLUSION: There is no consensus on use of the compression screw and practice does not converge with seniority. Teaching appears to transmit practice rather than mechanism. Explicit teaching, and a comparative study of retention versus removal, are warranted.

DOI: 10.1016/j.surge.2026.10.005

Team MERRIT – Medical, endocrine, respiratory and renal integrated therapy team - Improving timely, specialist in patient therapy response and intervention (2026)

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Type of publication:

Service improvement case study

Author(s):

*Clare Garton

Citation:

SaTH Improvement Hub, September 2026

SMART Aim:

By 31 March 2027, MERRIT aims to strengthen three connected measures: referral response, time on caseload, and alignment of daily clinical demand–capacity as evidenced an improvement in those metrics (see poster for targets).

Link to PDF poster

Elective Hub High Flow Theatre List: Combined Robotic & Non-Robotic Double List (2026)

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Type of publication:

Service improvement case study

Author(s):

*Saurav Chakravartty, *Adam Farquharson, *Rebekah Tudor

Citation:

SaTH Improvement Hub, September 2026

SMART Aim:

To improve elective performance by increasing cases per list and achieving >85% theatre utilisation on 23 September 2026.

Link to PDF poster

Improving Identification and Coding of Chronic Kidney Disease (CKD) in Patients with eGFR <60 in General Practice (2026)

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Type of publication:

Service improvement case study

Author(s):

*Rebecca Osborn

Citation:

SaTH Improvement Hub, April 2026

SMART Aim:

To improve the accurate coding of eligible patients with chronic kidney disease (CKD) on EMIS from a baseline of 71% within 5 weeks by implementing targeted interventions in primary care.

Link to PDF poster

QMS 90-day Audit: Therapy Centre (2026)

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Type of publication:

Service improvement case study

Author(s):

*Gemma Styles

Citation:

SaTH Improvement Hub, October 2026

SMART Aim:

For the Therapy centre to improve their 4 centre drivers (inpatient response time, complaints, CCTH inpatient response, time, CCTH outpatient activity) using QMS methodology as evidenced by metrics by September 2026

Link to PDF poster