Improving the selection of patients for upper gastrointestinal endoscopy.

Naji, Simon Alexander; Brunt, P. W.; Hagen, Suzanne; Mowat, N. A. G.; Russell, IT; Sinclair, T. S.; Tang, Thinh

doi:10.1136/gut.34.2.187

Cited by 35 publications

(15 citation statements)

References 17 publications

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“…Upper gastrointestinal endoscopy has become a widely applied diagnostic tool in patients with dyspepsia; most studies have reported that as many as 30±50% of upper gastrointestinal endoscopies show normal ®ndings. 24 In order to reduce the endoscopic workload, case selection, based on empirical antisecretory treatment 15,25 and H. pylori testing, 17±19 has been proposed, but such an approach may result in underuse of the procedure, while serious gastroduodenal diseases could be missed. In this study, upper gastrointestinal endoscopies judged to be appropriate did not yield more relevant lesions than those judged to be inappropriate.…”

Section: Resultsmentioning

confidence: 99%

“…In practice, the diagnoses sought are reflux oesophagitis, gastric and duodenal ulcers and gastric cancer. Upper gastrointestinal endoscopy has become a widely applied diagnostic tool in patients with dyspepsia; most studies have reported that as many as 30–50% of upper gastrointestinal endoscopies show normal findings 24 . In order to reduce the endoscopic workload, case selection, based on empirical antisecretory treatment 15 , 25 and H. pylori testing, 17–19 has been proposed, but such an approach may result in underuse of the procedure, while serious gastroduodenal diseases could be missed.…”

Section: Discussionmentioning

confidence: 99%

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Appropriateness and diagnostic yield of upper gastrointestinal endoscopy in an open‐access endoscopy system: a prospective observational study based on the Maastricht guidelines

Manes

Balzano

Marone³

et al. 2002

Aliment Pharmacol Ther

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Aim: To test the appropriateness of referrals for upper gastrointestinal endoscopy in Campania, Italy, using the criteria of the Maastricht Consensus. Patients: Patients undergoing endoscopy during a 1‐week period in 21 Endoscopy Services were considered prospectively. The reasons for endoscopy were dyspeptic symptoms, history of peptic ulcer and assessment after treatment. The age, sex, symptoms, history of peptic ulcer (previous endoscopic or radiographic examinations and treatment), endoscopic diagnosis and H. pylori status were recorded. The indications for endoscopy were evaluated according to the Maastricht guidelines. Results: Two hundred and sixteen of 706 patients presented with reflux symptoms, 430 with dyspeptic symptoms, 38 with alarm symptoms and 22 with atypical symptoms. Endoscopy was normal in 376 cases (53.2%); duodenal ulcer was found in 219, gastric ulcer in 45, oesophagitis in 82 and gastric cancer in six. All patients with cancer were older than 45 years, and four presented with alarm symptoms. In 398 cases (56%), endoscopy was considered not to be indicated: 250 patients with a previous diagnosis of ulcer without a change in symptoms, 38 patients in order to confirm eradication and 110 patients younger than 45 years with dyspepsia without alarm symptoms. Conclusions: A large number of endoscopic examinations could be avoided by following the guidelines of the Maastricht Consensus. In order to reduce endoscopic workload, strategies for educating physicians should be pursued.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Appropriateness and diagnostic yield of upper gastrointestinal endoscopy in an open‐access endoscopy system: a prospective observational study based on the Maastricht guidelines

Manes

Balzano

Marone³

et al. 2002

Aliment Pharmacol Ther

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“…Nevertheless, the value of a negative endoscopy should not be overlooked, as it can influence the subsequent management of the patients, and allows unnecessary therapies to be excluded. In a previous study, 67% of the negative endoscopies in adult patients were judged to have influenced patient management 28 …”

Section: Discussionmentioning

confidence: 99%

“…In a previous study, 67% of the negative endoscopies in adult patients were judged to have influenced patient management. 28 The mean number of GI endoscopies was 166.5 per year before the publication of Rome II criteria, while it increased to 236 per year after the publication of the diagnostic criteria. This data could be explained by several factors.…”

Section: Discussionmentioning

confidence: 99%

Impact of the Rome II paediatric criteria on the appropriateness of the upper and lower gastrointestinal endoscopy in children

Miele

Giannetti

Martinelli

et al. 2010

Aliment Pharmacol Ther

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“…. lcctive [3]. Another example is preoperative dipyridamole thallium scanning which is routinely done in some centres to identify patients at a high risk of cardiac complications during major vascular surgery.…”

Section: Iesmentioning

confidence: 99%