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

Abstract

There is a high likelihood of inappropriate referrals for colonoscopy in an open-access endoscopy system. The diagnostic yield of the procedure is dependent on the appropriateness of indication and referring physician's specialty. Certain indications "not listed" in the guidelines have an intermediate diagnostic yield and further studies are required to evaluate whether they should be included in future revisions of the ASGE guidelines.

Appropriateness of colonoscopy in Cocody teaching hospital center in 2010: A prospective study using criteria established by the European panel on the appropriateness of gastrointestinal endoscopy (EPAGE)

“…According to Coriat et al [19] using the criteria of ANAES 2004, the appropriateness of colonoscopies was 55%. Using the reference of the ASGE, Siddique [20], Jabar [21] and Chan [22] respectively reported numbers of 64%, 84% and 57.9%. The main factors according to several authors [13,16,19,23] Copyright © 2012 SciRes.…”

“…The latter number was found by Burnand et al [17] from colonoscopies performed in patients admitted exclusively for colorectal cancer screening, which was none indication in our work. In most other studies [14,[19][20][21][27][28][29]31] using or not the EPAGE criteria , proportion of significant lesions was higher in the order of 23% to 45%. The largest proportion of colonoscopy with inappropriate EPAGE criteria in our study could be the main reason.…”

“…Thus, according to Chan [22], 12.9% of 380 colonoscopies were inappropriate. Siddique [20] Bersani [28] and Morini [29] were reported respectively 20%, 37% and 29% of inappropriate colonoscopy on ASGE criteria. A study relied on the criteria of a Swiss panel found from Bosset et al 13% of inappropriate colonoscopy [15].…”

“…The largest proportion of colonoscopy with inappropriate EPAGE criteria in our study could be the main reason. Because in several studies [13,16,[19][20][21][22]31], there was a link between appropriateness of colonoscopy and significant lesion. This relationship was still observed in the study of Kmieciak (EPAGE I criteria [12]) nor in that of Chan (ASGE criteria [22]).…”

Indicações de colonoscopia versus achado de pólipos e neoplasias colorretais

“…Siddique et al mostraram que as colonoscopias com indicação apropriada possuem índice diagnóstico de 40 a 45%, enquanto as com indicação inapropriada apresentam índice diagnóstico de apenas 15 a 20% 12 . Assim, sintomas abdominais vagos sem indícios de sangramento, incontinência e constipação crônica são indicações com baixo índice diagnóstico 6,7 .…”