{
  "abstract": "Introduction Discrete event simulation (DES) can evaluate the impact of service redesign on capacity, flow, and waiting times which are key challenges for endoscopy services under sustained demand pressure. However, the extent, quality, and consistency of DES applications in endoscopy service planning remains unclear, representing a strategic knowledge gap. This scoping review aimed to map and critically evaluate how DES has been applied to endoscopy services, identifying methodological gaps relevant to service planning and pathway redesign, with particular focus on novel diagnostic tools such as Capsule sponge.Methods Following JBI guidance, a comprehensive search of Medline, EMBASE, HMIC, Web of Science, Econpapers and Google Scholar was conducted. Two reviewers independently screened studies reporting DES models in endoscopy services. Data were extracted on study question, modelling context, methodological parameters, outcomes and validation.  The protocol was registered prospectively on the Open Science Framework.Results From 627 identified studies, 17 were included, demonstrating limited and heterogeneous applications of DES in endoscopy services. DES was primarily applied (94.12% of studies) to model capacity, patient waiting times, and resource utilisation, with limited modelling of workforce or recovery constraints. Model parameters lacked standardisation across studies; procedure rooms were included in 82.35% of studies, whereas other parameters were less common, such as equipment (including endoscopes (47.06%)) and staff (including nurses (47.06%)). All studies used healthcare records or clinical sources for parameters, with the additional use of literature reviews (64.71%), expert opinion (58.82%), expert consensus (25%) and population forecasting (29.41%). The measurement of outcomes also varied, with 82.35% focusing on patient waiting times, and the same proportion assessing patient demand for services; there was a lower focus on resource utilisation outcomes such as nurses (41.18%) and recovery beds (47.06%), showing under-modelling of workforce and recovery capacity. The lack of validation was as a key limitation (see figure 1); validation was predominantly face-based (94.12%), with fewer than half undertaking sensitivity analyses or external validation (47.06%).Conclusion This scoping review highlights important implications for gastroenterology service planning in the UK. The application of DES within endoscopy services remains inconsistent with substantial methodological heterogeneity and limited validation. Nevertheless, existing DES models demonstrate clear potential to inform service re-design and predict its impact. In the context of NHS priorities to improve productivity and reduce waiting times, these findings highlight the need for transparent, standardised and UK-relevant DES models to support endoscopy capacity and service planning, including the evaluation of novel diagnostic pathways.Abstract P275 Figure 1",
  "authors": [
    {
      "affiliations": [
        "University of Cambridge, Cambridge, United Kingdom"
      ],
      "name": "Sneha Daga"
    },
    {
      "affiliations": [
        "Academic Unit of Health Economics, University of Leeds, Leeds, United Kingdom"
      ],
      "name": "Armando Vargas-Palacios"
    },
    {
      "affiliations": [
        "Academic Unit of Health Economics, University of Leeds, Leeds, United Kingdom"
      ],
      "name": "Ramzi Fayad"
    },
    {
      "affiliations": [
        "Academic Unit of Health Economics, University of Leeds, Leeds, United Kingdom",
        "Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom"
      ],
      "name": "Katie Spencer"
    },
    {
      "affiliations": [
        "University of Cambridge, Cambridge, United Kingdom"
      ],
      "name": "Andreas Hadjinicolaou"
    }
  ],
  "title": "P275 How are simulation models used in endoscopy departments? A scoping review",
  "uid": "4b2977c8-2e04-5c47-b132-daeadf0e8160"
}