Implementation of a biopsy protocol to improve detection of esophageal eosinophilia:a Danish registry-based study
| Autor: | Mogens Vyberg, Per Ejstrud, Peter Thaysen Laurberg, Asbjørn Mohr Drewes, Anne Lund Krarup |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Biopsy Denmark Danish 03 medical and health sciences 0302 clinical medicine Interquartile range Internal medicine medicine Humans Eosinophilia Registries Eosinophilic esophagitis Protocol (science) medicine.diagnostic_test business.industry Gastroenterology Eosinophilic Esophagitis medicine.disease Dysphagia language.human_language Endoscopy 030220 oncology & carcinogenesis language 030211 gastroenterology & hepatology medicine.symptom business |
| Zdroj: | Krarup, A L, Drewes, A M, Ejstrud, P, Laurberg, P T & Vyberg, M 2021, ' Implementation of a biopsy protocol to improve detection of esophageal eosinophilia : a Danish registry-based study ', Endoscopy, vol. 53, no. 1, pp. 15-24 . https://doi.org/10.1055/a-1206-0852 |
| DOI: | 10.1055/a-1206-0852 |
| Popis: | Background In the North Denmark Region (580 272 inhabitants), only 0–4 cases of possible eosinophilic esophagitis (EoE) were identified annually in 1999–2010, suggesting underdiagnosis. This study aimed to increase the diagnosis of EoE by introducing a regional biopsy protocol for patients with dysphagia. Methods In 2011, leaders of regional endoscopy units attended a consensus meeting where a biopsy protocol was proposed. The national pathology registry was used to identify patients with esophageal eosinophilic inflammation during 2007–2017. Results Discussion resulted in consensus on a protocol to take eight biopsy samples in dysphagia patients (four biopsies from 4 cm and 14 cm above the esophagogastric junction–“4–14–4 rule”) regardless of the macroscopic appearance, and to code eosinophilia systematically in the pathology registry. A pictogram showing the 4–14–4 rule was sent to all endoscopy units. The number of patients with esophageal eosinophilia detected per year increased 50-fold after the protocol was implemented in 2011 (median of 1 [interquartile range 0–3] vs. 52 [47–56]; P Conclusions A consensus-based biopsy protocol and improved coding of eosinophilia in the pathology registry resulted in a 50-fold increase in patients diagnosed with esophageal eosinophilia/year. These patients can now receive treatment. The effort to establish the protocol and change the culture of endoscopists and pathologists was minimal. |
| Databáze: | OpenAIRE |
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