A European view of diagnostic yield and appropriateness of colonoscopy

Details

Serval ID
serval:BIB_DCEB13C66C90
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
A European view of diagnostic yield and appropriateness of colonoscopy
Journal
Hepato-Gastroenterology
Author(s)
Gonvers Jean-Jacques, Harris Jennifer K., Wietlisbach Vincent, Burnand Bernard, Vader John-Paul, Froehlich Florian
Working group(s)
European EPAGE Study Group
ISSN
0172-6390
Publication state
Published
Issued date
2007
Peer-reviewed
Oui
Volume
54
Number
75
Pages
729-735
Language
english
Abstract
BACKGROUND/AIMS: This study's purpose was to examine the relationship between appropriateness criteria and diagnostic yield of colonoscopy. METHODOLOGY: This observational study prospectively included consecutive patients referred for colonoscopy from 21 centers in 11 countries. Patient, center, and colonoscopy characteristics were collected. Significant diagnoses included cancer, adenomatous polyps, angiodysplasia, and new diagnoses of inflammatory bowel disease. Appropriateness criteria were developed by the European Panel on the Appropriateness of Gastrointestinal Endoscopy (EPAGE) using the RAND Appropriateness Method. Determinants associated with a significant diagnosis were examined using multiple logistic regression. RESULTS: 5,213 patients who underwent diagnostic colonoscopy were included in the study. There were 1,227 (24%) significant diagnoses made, including 218 (4%) cancers and 735 (14%) adenomatous polyps. Among patients who had a significant diagnosis, 53% had an appropriate indication, 25% had an uncertain indication and 22% had an inappropriate indication. Having an appropriate indication, increasing age, and male sex increased the odds of finding a significant diagnosis at colonoscopy. CONCLUSIONS: Appropriateness criteria enhanced the detection of significant lesions, thereby demonstrating one way to enhance quality of care. However, appropriateness criteria will never perform better than the imperfect relationship between clinical symptoms and diagnostic yield.
Keywords
Colonoscopy, Colonoscopy/standards, Colonoscopy/statistics & numerical data, Europe, Female, Guideline Adherence, Humans, Intestinal Diseases, Intestinal Diseases/diagnosis, Male, Middle Aged
Pubmed
Web of science
Create date
05/02/2008 12:22
Last modification date
20/08/2019 16:01
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