The present and future of gastroenterology and hepatology: an international SWOT analysis (the GASTROSWOT project)

Enrique de-Madaria; José J Mira; Irene Carrillo; Waqqas Afif; Daphne Ang; Marina Antelo; Steven Bollipo; Antoni Castells; Prabhleen Chahal; Henriette Heinrich; Joanna K Law; Monique E van Leerdam; Sabela Lens; Rahul Pannala; San Hyoung Park; Atoosa Rabiee; Edoardo V Savarino; Vikesh K Singh; John Vargo; Aline Charabaty; Joost P H Drenth

doi:10.1016/S2468-1253(21)00442-8

The present and future of gastroenterology and hepatology: an international SWOT analysis (the GASTROSWOT project)

Lancet Gastroenterol Hepatol. 2022 May;7(5):485-494. doi: 10.1016/S2468-1253(21)00442-8. Epub 2022 Mar 2.

Authors

Enrique de-Madaria¹, José J Mira², Irene Carrillo², Waqqas Afif³, Daphne Ang⁴, Marina Antelo⁵, Steven Bollipo⁶, Antoni Castells⁷, Prabhleen Chahal⁸, Henriette Heinrich⁹, Joanna K Law¹⁰, Monique E van Leerdam¹¹, Sabela Lens¹², Rahul Pannala¹³, San Hyoung Park¹⁴, Atoosa Rabiee¹⁵, Edoardo V Savarino¹⁶, Vikesh K Singh¹⁷, John Vargo¹⁸, Aline Charabaty¹⁹, Joost P H Drenth²⁰

Affiliations

¹ Gastroenterology Department, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research, Alicante, Spain.
² Atenena Research Group, Foundation for the Promotion of Health and Biomedical Research of Valencia Region, FISABAO, Sant Joan d'Alacant, Spain; Department of Health Psychology, Miguel Hernández University of Elche, Elche, Spain.
³ Division of Gastroenterology, McGill University Health Centre, Montreal, QC, Canada.
⁴ Department of Gastroenterology, Changi General Hospital, Singapore, Singapore.
⁵ Oncology Section, Dr C Bonorino Udaondo Gastroenterology Hospital, Buenos Aires, Argentina.
⁶ Department of Gastroenterology, John Hunter Hospital, Newcastle, NSW, Australia; School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia.
⁷ Gastroenterology Department, IDIBAPS, CIBERehd, University of Barcelona, Barcelona, Spain; Hospital Clinic of Barcelona, IDIBAPS, CIBERehd, University of Barcelona, Barcelona, Spain.
⁸ Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH, USA.
⁹ Stadtspital Waid und Triemli Abteilung für Gastroenterologie, University of Zurich, Zurich, Switzerland.
¹⁰ Virginia Mason Medical Center, Seattle, WA, USA.
¹¹ Department of Gastrointestinal Oncology, Netherlands Cancer Institute, Amsterdam, Netherlands; Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, Netherlands.
¹² Liver Unit, IDIBAPS, CIBERehd, University of Barcelona, Barcelona, Spain.
¹³ Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic Arizona, Phoenix, AZ, USA.
¹⁴ Department of Gastroenterology, and Inflammatory Bowel Disease Center, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
¹⁵ Division of Gastroenterology and Hepatology, Washington DC Veterans Affairs Medical Center, Washington, DC, USA.
¹⁶ Gastroenterology Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.
¹⁷ Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
¹⁸ Department of Gastroenterology, Hepatology and Nutrition, Digestive Diseases and Surgery Institute, Cleveland Clinic, Cleveland, OH, USA.
¹⁹ Division of Gastroenterology, Sibley Memorial Hospital, Johns Hopkins University, Washington, DC, USA.
²⁰ Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, Netherlands. Electronic address: joostphdrenth@cs.com.

PMID: 35247318
DOI: 10.1016/S2468-1253(21)00442-8

Abstract

GASTROSWOT is a strategic analysis of the current and projected states of the different subspecialties in gastroenterology that aims to provide guidance for research, clinical, and financial planning in gastroenterology. We executed a consensus-based international strengths, weaknesses, opportunities, and threats (SWOT) analysis. Four general coordinators, six field coordinators, and 12 experts participated in the study. SWOTs were provided for the following fields: neurogastroenterology, functional gastrointestinal disorders, and upper gastrointestinal diseases; inflammatory bowel disease; pancreatology and biliary diseases; endoscopy; gastrointestinal oncology; and hepatology. The GASTROSWOT analysis highlights the following in the current state of the field of gastroenterology: the incidence and complexity of several gastrointestinal diseases, including malignancies, are increasing; the COVID-19 pandemic has affected patient care on several levels; and with the advent of technical innovations in gastroenterology, a well trained workforce and strategic planning are required to optimise health-care utilisation. The analysis calls attention to the following in the future of gastroenterology: artificial intelligence and the use of big data will speed up discovery and smarter health-care provision in the field; the growth and diversification of gastroenterological specialties will improve specialised care for patients, but could promote fragmentation of care and health system inefficiencies; and furthermore, thoughtful planning is needed to reach an effective balance between the need for subspecialists and the value of general gastroenterology services.

Publication types

Review

MeSH terms

Artificial Intelligence
COVID-19*
Endoscopy, Gastrointestinal
Gastroenterology*
Gastrointestinal Diseases* / diagnosis
Gastrointestinal Diseases* / therapy
Humans
Pandemics