Appropriateness of colonoscopy in Europe (EPAGE II): presentation of methodology, general results, and analysis of complications.

Details

Serval ID
serval:BIB_6334EA8CB048
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Appropriateness of colonoscopy in Europe (EPAGE II): presentation of methodology, general results, and analysis of complications.
Journal
Endoscopy
Author(s)
Juillerat Pascal, Peytremann Bridevaux Isabelle, Vader John-Paul, Arditi Chantal, Schusselé Filliettaz Séverine, Dubois Robert W., Gonvers Jean-Jacques, Froehlich Florian, Burnand Bernard, Pittet Valérie
ISSN
1438-8812
Publication state
Published
Issued date
2009
Peer-reviewed
Oui
Volume
41
Number
3
Pages
240-246
Language
english
Abstract
BACKGROUND AND STUDY AIMS: Appropriate use of colonoscopy is a key component of quality management in gastrointestinal endoscopy. In an update of a 1998 publication, the 2008 European Panel on the Appropriateness of Gastrointestinal Endoscopy (EPAGE II) defined appropriateness criteria for various colonoscopy indications. This introductory paper therefore deals with methodology, general appropriateness, and a review of colonoscopy complications. METHODS:The RAND/UCLA Appropriateness Method was used to evaluate the appropriateness of various diagnostic colonoscopy indications, with 14 multidisciplinary experts using a scale from 1 (extremely inappropriate) to 9 (extremely appropriate). Evidence reported in a comprehensive updated literature review was used for these decisions. Consolidation of the ratings into three appropriateness categories (appropriate, uncertain, inappropriate) was based on the median and the heterogeneity of the votes. The experts then met to discuss areas of disagreement in the light of existing evidence, followed by a second rating round, with a subsequent third voting round on necessity criteria, using much more stringent criteria (i. e. colonoscopy is deemed mandatory). RESULTS: Overall, 463 indications were rated, with 55 %, 16 % and 29 % of them being judged appropriate, uncertain and inappropriate, respectively. Perforation and hemorrhage rates, as reported in 39 studies, were in general < 0.1 % and < 0.3 %, respectively CONCLUSIONS: The updated EPAGE II criteria constitute an aid to clinical decision-making but should in no way replace individual judgment. Detailed panel results are freely available on the internet (www.epage.ch) and will thus constitute a reference source of information for clinicians.
Keywords
Colonoscopy/adverse effects, Colonoscopy/methods, Europe, Humans, Treatment Outcome
Pubmed
Web of science
Open Access
Yes
Create date
04/08/2009 9:25
Last modification date
20/08/2019 14:19
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