Appropriateness of indication and diagnostic yield of colonoscopy: First report based on the 2000 guidelines of the American Society for Gastrointestinal Endoscopy

Introduction: Advances in endoscopy and open-access systems led to an increase in endoscopic procedures. However, overuse of endoscopy has been consistently reported. This study aims to assess the appropriateness of esophagogastroduodenoscopy (EGD) and colonoscopy referral in the private and public setting. Patients and Methods: We conducted a prospective, multicenter study at 2 public and 5 private endoscopy units. Patients scheduled for elective EGD or colonoscopy were enrolled. Clinical data and endoscopy findings were recorded. Appropriateness of endoscopy was defined according to the American Society for Gastrointestinal Endoscopy guidelines (for EGD) and the European Panel on Appropriateness of Gastrointestinal Endoscopy II (for colonoscopy). Results: Regarding EGD: 215 patients enrolled (43.7% were males) with a mean age of 61.0 ± 15.1 years; 54.0% (n = 116) were in public hospitals. Referral by a gastroenterologist was made for 34.9% (n = 75). Appropriate indications were made for 62.3% (n = 134): 42.4% in private versus 79.3% in public endoscopy units (odds ratio [OR] 5.20; 95% confidence interval [CI] 2.85–9.49; p < 0.01). Rate of appropriate EGD was 74.7% for gastroenterologist referral and 56.1% for other specialties (OR 2.31; 95% CI 1.24–4.28; p < 0.01). Diagnostic yield for relevant findings was 47.9%. No association between indication appropriateness, gastroenterologist referral, and relevant endoscopic findings was found. Regarding colonoscopy: 287 patients enrolled (49.1% were males) with a mean age of 60.4 ± 14.4 years; 48.1% (n = 138) were in public hospitals. Referral by a gastroenterologist was made for 20.6% (n = 59). Appropriate indications were made for 70.0% (n = 201): 53.0% in private vs. 88.4% in public endoscopy units (OR 6.75; 95% CI 3.66–12.47; p < 0.01). Diagnostic yield was 57.1%. Relevant endoscopic diagnosis was associated with indication: 63.2% in the appropriate vs. 43.0% in the nonappropriate indication group (p < 0.05). Discussion: A significant percentage of endoscopies, mainly in the private setting, were performed without an appropriate indication. This influenced the diagnostic yield. The use of adequate criteria is fundamental for the rational use of an open-access system.

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Appropriateness and diagnostic yield of upper gastrointestinal endoscopy in an open-access endoscopy system

Saudi Journal of Gastroenterology ◽

10.4103/1319-3767.118128 ◽

2013 ◽

Vol 19 (5) ◽

pp. 219 ◽

Cited By ~ 10

Author(s):

MajidA Almadi ◽

AbdulrahmanM Aljebreen ◽

Khalid Alswat

Keyword(s):

Open Access ◽

Gastrointestinal Endoscopy ◽

Diagnostic Yield ◽

Upper Gastrointestinal Endoscopy ◽

Upper Gastrointestinal

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Diagnostic yield of gastrointestinal endoscopy in North West Region Cameroon and trends in diagnosis over time

Pan African Medical Journal ◽

10.11604/pamj.2018.29.178.10785 ◽

2018 ◽

Vol 29 ◽

Cited By ~ 1

Author(s):

Jacob Kamdem ◽

Dennis Palmer ◽

Charles Barrier ◽

Richard Bardin ◽

James Allen Brown ◽

...

Keyword(s):

Gastrointestinal Endoscopy ◽

Diagnostic Yield ◽

North West ◽

West Region ◽

Over Time

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Indicadores de calidad de colangiopancreatografía retrógada endoscópica en un hospital nivel III asociados al desarrollo de pancreatitis aguda post-cpre

Revista del Cuerpo Médico del HNAAA ◽

10.35434/rcmhnaaa.2021.142.1028 ◽

2021 ◽

Vol 14 (2) ◽

pp. 132-138

Author(s):

Katherine Alexandra Pérez Acuña-Medina ◽

Cristian Díaz-Vélez

Keyword(s):

Gastrointestinal Endoscopy ◽

American Society

Objetivo: Evaluar la asociación entre los indicadores de calidad de colangiopancreatografía retrógada endoscópica (CPRE) y desarrollo de pancreatitis aguda post-CPRE en el Hospital Regional Lambayeque durante el período 2016–junio 2017. Material y métodos: estudio observacional, transversal analítico, retrospectivo. Población censal 539 y muestra 358. Se evaluaron historias clínicas usando un checklist de indicadores de calidad de “The American Society for Gastrointestinal Endoscopy (ASGE)”. Se usó media y desviación estándar para la edad y frecuencias absolutas y porcentajes para las demás variables. Se evaluó el porcentaje de cumplimiento de cada indicador. Se encontró la asociación entre indicadores de calidad y el desarrollo de pancreatitis usando razones de prevalencia (IC95%) y X2(p<0,05). Resultados: La edad promedio es 52,24+20,168, el 66,5% son mujeres. 98,3% de las CPREs tiene indicación apropiada; 0,3% no tiene consentimiento informado completo; 15,38% tuvo administración de antibiótico adecuada; 92,2% fueron realizadas por un endoscopista capacitado; en 96,9% se logró la canulación profunda, ninguno tuvo medición del tiempo de fluoroscopio, 65,1% logró extracción de cálculos <1cm, 95,5% logró la colocación de stent; ninguna tuvo reporte completo y en el 98,5% los efectos adversos fueron documentados. La tasa de pancreatitis fue 7%, de perforación 0,6% y de hemorragia 2,5%. Solo el 3,9% tuvo control en >14 días. Conclusiones: No existe asociación entre los indicadores de calidad de CPRE y el desarrollo de pancreatitis. No se cumplen todos los criterios de calidad. La pancreatitis post-CPRE tiene más posibilidad de presentarse en mujeres, pero menos en mayores de 65 años.

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