The Impact on Endoscopic Resource Utilization After a Targeted Intervention for Cost-Minimization of EGD and Colonoscopy

Kaitha, Sindhu; Salem, G; Zhao, Yan; Madhoun, Mohammad F.; Chen, Allshine; Tierney, William M.

doi:10.1038/ajg.2016.340

Cited by 4 publications

(3 citation statements)

References 11 publications

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“…Despite the obvious risk of potentially serious advance effects, not to mention the psychological trauma, some children experience when undergoing an invasive procedure, the unjustifiably high rate of EGDs for unspecific symptoms is further associated with a significant socioeconomic burden [13]. This accounts not only to the endoscopic procedure itself but also to the performance of mucosal biopsies in routine EGDs [17].…”

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confidence: 99%

Common Indications and The Diagnostic Yield of Esophagogastroduodenoscopy in Children with Gastrointestinal Distress

et al. 2018

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confidence: 99%

Common Indications and The Diagnostic Yield of Esophagogastroduodenoscopy in Children with Gastrointestinal Distress

et al. 2018

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“…The nonspecific finding of distal esophageal thickening (DET) has frequently prompted evaluation with esophagogastroduodenoscopy (EGD). However, in an era of value-based health care, it is important to minimize unnecessary costs, and this has been incentivized by the declining reimbursements in endoscopic procedures 17. In addition, there are associated costs from EGDs, including the processing of pathology specimens 17.…”

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confidence: 99%

“…However, in an era of value-based health care, it is important to minimize unnecessary costs, and this has been incentivized by the declining reimbursements in endoscopic procedures 17. In addition, there are associated costs from EGDs, including the processing of pathology specimens 17. When screening for gastroesophageal cancer according to the American Society for Gastrointestinal Endoscopy (ASGE) and European Panel on the Appropriateness of Gastrointestinal Endoscopy (EPAGE), inappropriate use of EGDs is significantly inefficient and not cost-effective 18.…”

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Endoscopic Evaluation of Radiologic Distal Esophageal Thickening

Leung

Mizrahi

Quintero

et al. 2020

Journal of Clinical Gastroenterology

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Goals: We aim to determine the incidence of esophagogastroduodenoscopies (EGDs) primarily performed for imaging findings of distal esophageal thickening (DET). We also aim to determine if patients with imaging findings of DET have a higher incidence of cancer, and to evaluate the risk factors associated with findings of malignancy. Background: The growth of diagnostic imaging has led to an increase in incidental findings of DET. This nonspecific finding frequently prompts an EGD for evaluation—many of which demonstrate benign conditions. There may be a misuse of valuable resources. Study: We performed a retrospective chart review of 1080 EGDs from January 2016 to July 2018 at the Veterans Affairs Medical Center, comparing EGDs for the indication of imaging report of DET with EGDs for other indications. Patient demographics, clinical history, imaging, procedure, and pathology reports were collected. Descriptive analysis and biostatistical analysis with χ2, Fisher exact, Wilcoxon rank sum, and Kruskal-Wallis tests were utilized in analyzing the data. Results: Of the 1080 total endoscopies, 8.2% (n=88) were done specifically because of the imaging findings of DET. Those who had EGDs performed because of DET had a higher percentage of abnormal esophageal findings and of cancer. A history of Barrett’s esophagus, tobacco use, and having gastrointestinal symptoms were not significant predictors of abnormal findings or of cancer for EGDs done for DET. Conclusions: There may be a role for EGDs performed for radiologic findings of DET. Even those without risk factors for malignancy should have EGDs performed for DET. Radiologists should consider reporting the DET size in order to determine if significant endoscopic findings correlate with wall thickness.

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