A Nine‐Year Audit of Open‐Access Upper Gastrointestinal Endoscopic Procedures: Results and Experience of a Single Centre

Keren, Dean; Rainis, Tova; Stermer, E; Lavy, Alexandra

doi:10.1155/2011/379014

Cited by 40 publications

(35 citation statements)

References 39 publications

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“…114,115 Elsewhere in Europe, appropriateness rates for endoscopy have been reported in Portugal, Spain, Italy, and Norway, with overuse accounting for between 13% and 33% of tests, 116–119 and at an Israeli center 16% of endoscopies were unnecessary. 120 Studies in the US have reported overuse rates as high as 60% 121 . In Saudi Arabia, which has open access to endoscopy, nearly half of procedures were inappropriate.…”

Section: Worldwide Prevalence Of Overusementioning

confidence: 99%

Evidence for overuse of medical services around the world

et al. 2017

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Section: Worldwide Prevalence Of Overusementioning

confidence: 99%

Evidence for overuse of medical services around the world

et al. 2017

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“…[15][16][17] Literature suggests that this has resulted in an increase in a number of unnecessary procedures which range from 5 to 49%. 19 Similarly they also found 440 (2.13%) gastric malignancies out of which 392 (1.90%) had appropriate indication and 48 (0.23%) had inappropriate indications. 19 The difference from our findings with this large study may be due to small sample size in our study.…”

Section: Discussionmentioning

confidence: 86%

“…19 Similarly they also found 440 (2.13%) gastric malignancies out of which 392 (1.90%) had appropriate indication and 48 (0.23%) had inappropriate indications. 19 The difference from our findings with this large study may be due to small sample size in our study. Hence, guidelines should be used cautiously in order not to miss important diagnosis and the clinical suspician and clinical judgements should always come before the guidelines.…”

Section: Discussionmentioning

confidence: 86%

Appropriateness of Indications of Upper Gastrointestinal Endoscopy and its Association With Positive Finding

et al. 2018

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Introduction: Upper Gastrointestinal Endoscopy(UGIE) is a frequently advised investigation for upper abdominal symptoms. Studies have questioned the appropriateness of indications for UGIE and have shown that inappropriate indications range from 5% to 49%. The unnecessary UGIE expose patients to the risk. The number of UGIE is rising in our region and we assume so is the number of unnecessary UGIE. With an aim to evaluate the appropriateness of the indications of UGIE and compare its association with positive findings, we conducted a cross-sectional descriptive study. Methods: All patients undergoing diagnostic UGIE during the study period were included in the study. Appropriateness of indications for UGIE was defined as per American Society for Gastrointestinal Endoscopy(ASGE) criteria as “appropriate” and “inappropriate”. UGIE endoscopy findings were classified as “significant” and “insignificant” based on endoscopy findings. The extent of this association between the appropriateness of indications and UGIE findings was expressed as the odds ratio (OR) of finding a relevant diagnosis in patients with an ‘‘appropriate’’ indication compared with those with an ‘inappropriate’’ indication. Results: Seventy-nine patients were included in the study. Fifty- two (65.8 %) of the indications were considered appropriate as per ASGE guidelines. Thirty-three (63.5%) of the appropriate indications has clinically significant finding as compared to seven (25.9%) of inappropriate indication with an odds ratio of 4.962 (95%CI:1.773 – 13.890, p=0.002) which is statistically significant. Conclusions: Appropriate indications have significantly higher rates of clinically significant findings. Use of guidelines may decrease the number of unnecessary procedures.

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“…We collapsed the diagnosis field into nine different binary (present/absent) covariate fields: achalasia, Barrett’s oesophagus, diverticulum, extrinsic compression, malignancy, peptic ulcer disease, polyps, varices and other diagnoses. Previous publications have classified OGD diagnoses into 1818 or 21 categories 19. We chose nine categories as these could be grouped easily from the diagnosis field options in the JETS database and the overall number of categories was minimised to simplify the multivariate analysis.…”

Section: Methodsmentioning

confidence: 99%