Clinical procedures used to diagnose inflammatory bowel disease: real-world evidence from a Danish nationwide population-based study.

Autor:	Rasmussen NF; Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark nathalie.fogh.rasmussen@rsyd.dk.; Research Unit of Molecular Diagnostics and Clinical Research, University Hospital of Southern Denmark, Aabenraa, Denmark., Green A; Steno Diabetes Center Odense, Odense University Hospital and Department of Clinical Research, University of Southern Denmark, Odense, Denmark., Allin KH; National Center of Excellence for Molecular Prediction of Inflammatory Bowel Disease, PREDICT, Department of Clinical Medicine, Faculty of Medicine, Aalborg University, Copenhagen, Denmark.; Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark., Iversen AT; National Center of Excellence for Molecular Prediction of Inflammatory Bowel Disease, PREDICT, Department of Clinical Medicine, Faculty of Medicine, Aalborg University, Copenhagen, Denmark.; Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark., Madsen GI; Department of Clinical Pathology, Odense University Hospital, Odense, Denmark., Pedersen AK; Department of Clinical Research, University Hospital of Southern Denmark, Aabenraa, Denmark., Wolff DL; Department of Clinical Research, University Hospital of Southern Denmark, Aabenraa, Denmark.; Internal Medicine Research Unit, University Hospital of Southern Denmark, Aabenraa, Denmark., Jess T; National Center of Excellence for Molecular Prediction of Inflammatory Bowel Disease, PREDICT, Department of Clinical Medicine, Faculty of Medicine, Aalborg University, Copenhagen, Denmark.; Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark., Andersen V; Research Unit of Molecular Diagnostics and Clinical Research, University Hospital of Southern Denmark, Aabenraa, Denmark.; Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark.
Jazyk:	angličtina
Zdroj:	BMJ open gastroenterology [BMJ Open Gastroenterol] 2022 Aug; Vol. 9 (1).
DOI:	10.1136/bmjgast-2022-000958
Abstrakt:	Objective: Although clinical guidelines exist, the diagnostic work-up for diagnosing inflammatory bowel disease (IBD) is complex and varies in clinical practice. This study used real-life data to characterise the current diagnostic procedures used to establish IBD diagnoses in a Danish nationwide setting. Design: Person-level data on patients diagnosed with IBD between 1 January 2014 and 30 June 2018 were linked between Danish health registers. Information on age, sex, registration of other gastrointestinal diseases, and diagnostic procedures (endoscopies, biopsies, and imaging) performed in relation to the first IBD hospital admission was analysed for the total study population and was stratified by IBD type, sex, and age. Results: The majority of the 12 871 patients with IBD included underwent endoscopy (84%), had a biopsy taken (84%), and/or underwent imaging procedures (44%). In total, 7.5% of the population (6% for Crohn's disease and 8% for ulcerative colitis) were diagnosed with IBD despite not undergoing any of these diagnostic procedures. Patients with Crohn's disease underwent more procedures than patients with ulcerative colitis (94% vs 92%, p<0.001). Children underwent slightly fewer diagnostic procedures than adults (92% vs 93%, p=0.004). Slightly more men underwent at least one procedure than women (92% vs 94%, p<0.001). Conclusion: For 7.5% of patients with IBD, this study did not detect any registrations of the recommended diagnostic procedures for establishing an IBD diagnosis. Further research is needed to examine whether these findings are mainly explained by limitations of the register data or also indicate shortcomings of the general approach to IBD. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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