ViewpointThe present and future of gastroenterology and hepatology: an international SWOT analysis (the GASTROSWOT project)
Introduction
Gastroenterological and liver diseases are prevalent in the general population and associated with considerable morbidity, mortality, and health-care costs.1 For example, irritable bowel syndrome (IBS) is one of the most prevalent conditions in gastroenterology, and direct and indirect costs related to IBS range from €6 billion to €8 billion per year in Europe.2 Gastroenterology as a specialty faces social, scientific, and technological challenges that need to be addressed in the upcoming years, through thoughtful planning and judicious analysis of the current and projected state of the field. The strengths, weaknesses, opportunities, and threats (SWOT) analysis grid is a widely used strategic planning technique that divides information into favourable and unfavourable, and internal and external, determinants of care.3 A SWOT analysis helps identify current strengths, opportunities for growth, weaknesses to address, and potential threats that are being faced in the field. As such, this framework is a simple yet powerful tool to generate meaningful information and build strategic recommendations.
Our aim was to use the SWOT framework to characterise the current and projected states of the different subspecialties in gastroenterology to provide guidance for future planning of clinical services and research. To this end we designed an international project, which we refer to as GASTROSWOT (panel).
Section snippets
Initial design and expert selection
Four general coordinators designed and led the study, two gastroenterologists (JPHD and EdM) and two psychologists specialised in quality of health-care research (JJM and IC). The two gastroenterologists also identified the different fields of gastroenterology to be analysed and identified gastroenterologists to participate as field coordinators (one per field). Field coordinators had to be proactive, widely-recognised experts in education or clinical research, or both, within their
Results
The main conclusions of GASTROSWOT for each field are summarised in the appendix (pp 2–8) and discussed in detail in this section.
Conclusion
This Viewpoint maps the present and future of gastroenterology as a discipline and highlights the challenges and opportunities from six fields within the specialty. We established a GASTROSWOT panel composed of experts with a wide range of expertise.
We identified pivotal themes in gastroenterology (figure). First, the incidence of many diseases affecting the gastrointestinal system is increasing. The epidemic of lifestyle-associated disorders such as metabolic syndrome has fuelled the rising
Declaration of interests
EdM is a consultant for Takeda Pharmaceutical Company, Abbott, and Mylan. WA received consultancy fees from AbbVie, Amgen, Arena Pharmaceuticals, Dynacare, Janssen, Merck, Novartis, Pfizer, Sandoz, and Takeda. SL received speaker and advisor fees from Gilead and AbbVie, and grants from Gilead. RP is a consultant to HCL Technologies, and on the scientific advisory board at Nestlé. VKS is consultant to AbbVie and Nestlé Health Science and has received grant funding from Orgenesis and Theraly. JV
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