Appropriateness of colonoscopy: diagnostic yield and safety in guidelines
| Autor: | Monica Navino, Gabrio Bassotti, P. Niola, C. Verna, Edda Battaglia, Mario Grassini |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Yield (finance) Cost-Benefit Analysis MEDLINE Colonoscopy Letters To The Editor Colonic Diseases medicine Humans Medical physics Prospective Studies False Negative Reactions Aged Aged 80 and over medicine.diagnostic_test business.industry Gastroenterology General Medicine Middle Aged Surgery Italy Colonic Neoplasms Practice Guidelines as Topic Female business Rapid Communication |
| Zdroj: | World journal of gastroenterology. 13(12) |
| ISSN: | 1007-9327 |
| Popis: | To evaluate if the guidelines for the appropriateness of performing colonoscopy by American Society for Gastrointestinal Endoscopy (AGSE) and Italian Society of Digestive Endoscopy (SIED) yield a good diagnostic efficacy and do not present risks of missing important colonic pathologies in an Italian population sample.A total of 1017 consecutive patients (560 men and 457 women; mean age 64.4 +/- 16 years) referred to an open-access endoscopy unit for colonoscopy from July 2004 to May 2006 were evaluated according to ASGE and SIED guidelines for appropriateness of performing the procedure. Diagnostic yield was defined as the percentage of relevant colonic pathologies of the total number of colonoscopies performed.About 85.2% patients underwent colonoscopy that was considered appropriate based on at least one ASGE or SIED criterion, while it was considered inappropriate for 14.8% of patients. The diagnostic yield of colonoscopy was significantly higher for appropriate colonoscopies (26.94% vs 10.6%, P0.001) than for inappropriate colonoscopies (5.3%). There was no missed colorectal cancer following the ASGE/SIED criteria.ASGE/SIED guidelines have shown a good diagnostic yield and the rate of missing relevant colonic pathologies seems very low. Unfortunately, the percentage of inappropriate referrals for colonoscopy in an open-access endoscopy system is still high, despite the number of papers published on the issue and the definition of international guidelines. Further steps are required to update and standardize the guidelines to increase their diffusion and to promote educational programs for general practitioners. |
| Databáze: | OpenAIRE |
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