| STRIDE-II recommendations |
-Lack of robust evidence |
- Standardization of definitions and outcomes to facilitate clearer communication between professionals and patients - Research (validation studies, prognosis studies): Promote clinical research focusing on the validation of STRIDE-II targets, particularly in prognostic studies, to provide stronger evidence supporting the recommendations
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-Ambitious or stringent treatment goals (eg, transmural healing) |
- Alternative treatment goals: Adopt flexible treatment goals that consider various disease states and patient responses. For example, setting more practical and achievable goals for patients who cannot meet more stringent criteria like transmural healing - Generation of composite scores: Use composite indices that combine several indicators of disease activity to better evaluate patient progress - More flexible cutoffs: Implement less rigid thresholds to account for patient variability in achieving clinical goals, ensuring treatment remains realistic - New drugs and new treatment strategies
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-Scope too general (eg, no subgroups, complex patients) |
- Subgroup analysis: Perform detailed subgroup analyses in clinical studies to provide personalized treatment strategies for specific populations (eg, pediatric or elderly patients) - Patient stratification: Stratify patients based on disease severity, comorbidities, and response to previous treatments, allowing for more tailored treatment protocols - Adaptations to specific profiles: Adjust treatment strategies to match individual patient profiles, considering factors like genetics, disease phenotype, and lifestyle
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| Gastroenterologists |
-Lack of knowledge and skills |
- Educational activities: Organize continuous medical education (CME) workshops, webinars, and certifications aimed at increasing the awareness and competencies of gastroenterologists regarding STRIDE-II recommendations
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-Lack of time |
- Consultation optimization: Streamline patient consultations by incorporating tools like pre-consultation questionnaires or digital health monitoring platforms to ensure efficient data gathering before meetings - Checklists generation: Develop checklists for key clinical steps in implementing STRIDE-II targets, ensuring that important aspects of patient care are not overlooked during time-constrained consultations
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| Health system |
-Poor access (eg, MRE, ultrasound)
-Lack of resources |
- Improve availability: Advocate for the allocation of more resources and infrastructure that allow for the wider availability of diagnostic tools like MRE and ultrasound in healthcare settings - Local adaptations: Tailor STRIDE-II implementations based on local health system limitations, allowing for the use of available technologies or alternative methods for monitoring disease progress
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-Lack of knowledge and skills in other health professionals (eg, endoscopists) |
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