DECIDE: Delphi Expert Consensus Statement on Inflammatory Bowel Disease Dysplasia Shared Management Decision-Making

Area of Science:

• Gastroenterology and Colorectal Surgery
• Decision Science

Background:

• Inflammatory bowel disease (IBD) colitis-associated dysplasia management involves surveillance or surgery, but cancer progression uncertainty complicates decisions.
• Patients often have a high threshold for accepting prophylactic surgery (proctocolectomy).
• Individualized discussions between patients and multidisciplinary teams are crucial for optimal management.

Purpose of the Study:

• To develop a toolkit supporting structured, multidisciplinary, and shared decision-making for colitis-associated dysplasia management.
• To aid clinicians in counseling patients regarding high cancer risk dysplasia in IBD.

Main Methods:

• Consolidated evidence from systematic literature reviews, mixed-methods studies, and expert recommendations.
• Developed consensus statements via an international, multidisciplinary modified electronic Delphi process.
• Achieved 80% agreement threshold for consensus on each statement.

Main Results:

• A Delphi panel of 31 international members (gastroenterologists, colorectal surgeons, nurse specialists) participated.
• Generated 18 consensus statements after two rounds of anonymous voting.
• The final toolkit includes clinician and patient decision aids.

Conclusions:

• Developed international consensus recommendations for managing high cancer risk colitis-associated dysplasia.
• The toolkit facilitates shared decision-making between healthcare professionals and patients.
• Supports evidence-based best practices in dysplasia management for IBD patients.