Accurate and timely diagnosis of eosinophilic esophagitis improves over time in Europe: an analysis of the EoE CONNECT Registry
| Autor: | Pilar Navarro, Emilio J Laserna‐Mendieta, Sergio Casabona, Edoardo Savarino, María Teresa Pérez‐Fernández, Matteo Ghisa, Isabel Pérez‐Martínez, Danila Guagnozzi, Antonia Perelló, Antonio Guardiola‐Arévalo, Francesca Racca, Elena Betoré, Leonardo Blas‐Jhon, Anne Lund Krarup, Verónica Martín‐Domínguez, Daria Maniero, Adolfo Suárez, Ronald Llerena‐Castro, Luisa de la Peña‐Negro, Alicia Granja Navacerrada, Gaia Pellegatta, Javier Alcedo, Lonore de Hurtado Mendoza‐Guena, Sara Feo‐Ortega, Jesús Barrio, Carolina Gutiérrez‐Junquera, Sonia Fernández‐Fernández, Susana De la Riva, Juan E Navés, Silvia Carrión, Constanza Ciriza de los Ríos, Natalia García‐Morales, Juan Armando Rodríguez‐Oballe, Raffaela Dainese, Alba Rodríguez‐Sánchez, María Lluisa Masiques‐Mas, María Teresa Palomeque, Cecilio Santander, Sonsoles Tamarit‐Sebastián, Ángel Arias, Alfredo J Lucendo |
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| Přispěvatelé: | [Navarro P] Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Spain. Instituto de Investigación Sanitaria La Princesa, Madrid, Spain. Instituto de Investigación Sanitaria de Castilla‐La Mancha (IDISCAM), Tomelloso, Spain. [Laserna-Mendieta EJ] Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Spain. Instituto de Investigación Sanitaria La Princesa, Madrid, Spain. Instituto de Investigación Sanitaria de Castilla‐La Mancha (IDISCAM), Tomelloso, Spain. Laboratory Medicine Department. Hospital Universitario de La Princesa, Madrid, Spain. [Casabona S, Pérez-Fernández MT] Instituto de Investigación Sanitaria La Princesa, Madrid, Spain. Department of Gastroenterology, Hospital Universitario de La Princesa, Madrid, Spain. [Savarino E, Ghisa M] Department of Surgery, Oncology and Gastroenterology, Gastroenterology Unit, Azienza Ospedaliera di Padova, Padova, Italy. [Masiques-Mas ML] Department of Pediatric Gastroenterology, Hospital General de Granollers, Granollers, Spain, Hospital General de Granollers |
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
Gastrointestinal
Digestive System Diseases::Gastrointestinal Diseases::Esophageal Diseases::Esophagitis::Eosinophilic Esophagitis [DISEASES] Delayed Diagnosis administración de los servicios de salud::calidad de la atención sanitaria::garantía de calidad de la atención sanitaria::directrices como asunto::guías de práctica clínica como asunto [ATENCIÓN DE SALUD] Deglutition Disorders/diagnosis diagnóstico::técnicas y procedimientos diagnósticos::técnicas diagnósticas quirúrgicas::endoscopia [TÉCNICAS Y EQUIPOS ANALÍTICOS DIAGNÓSTICOS Y TERAPÉUTICOS] Diagnòstic Health Services Administration::Quality of Health Care::Quality Assurance Health Care::Guidelines as Topic::Practice Guidelines as Topic [HEALTH CARE] Eosinophilia Humans Registries Endoscòpia Diagnostic delay Endoscopy Eosinophilic esophagitis Guideline Adherence Practice Guidelines as Topic Cross-Sectional Studies Enteritis Gastritis Deglutition Disorders Eosinophilic Esophagitis Gastroenterology Reflux gastroesofàgic enfermedades del sistema digestivo::enfermedades gastrointestinales::enfermedades del esófago::esofagitis::esofagitis eosinofílica [ENFERMEDADES] Oncology Eosinophilic Esophagitis/diagnosis Diagnosis::Diagnostic Techniques and Procedures::Diagnostic Techniques Surgical::Endoscopy [ANALYTICAL DIAGNOSTIC AND THERAPEUTIC TECHNIQUES AND EQUIPMENT] |
| Zdroj: | Navarro, P, Laserna-Mendieta, E J, Casabona, S, Savarino, E, Pérez-Fernández, M T, Ghisa, M, Pérez-Martínez, I, Guagnozzi, D, Perelló, A, Guardiola-Arévalo, A, Racca, F, Betoré, E, Blas-Jhon, L, Krarup, A L, Martín-Domínguez, V, Maniero, D, Suárez, A, Llerena-Castro, R, de la Peña-Negro, L, Navacerrada, A G, Pellegatta, G, Alcedo, J, de Hurtado Mendoza-Guena, L, Feo-Ortega, S, Barrio, J, Gutiérrez-Junquera, C, Fernández-Fernández, S, De la Riva, S, E Navés, J, Carrión, S, Ciriza de Los Ríos, C, García-Morales, N, Rodríguez-Oballe, J A, Dainese, R, Rodríguez-Sánchez, A, Masiques-Mas, M L, Palomeque, M T, Santander, C, Tamarit-Sebastián, S, Arias, Á & Lucendo, A J 2022, ' Accurate and timely diagnosis of Eosinophilic Esophagitis improves over time in Europe. An analysis of the EoE CONNECT Registry ', United European Gastroenterology Journal, vol. 10, no. 5, pp. 507-517 . https://doi.org/10.1002/ueg2.12240 Scientia |
| Popis: | Diagnostic delay; Endoscopy; Eosinophilic esophagitis Retraso en el diagnóstico; Endoscopia; Esofagitis eosinofílica Retard diagnòstic; Endoscòpia; Esofagitis eosinofílica Background: Poor adherence to clinical practice guidelines for eosinophilic esophagitis (EoE) has been described and the diagnostic delay of the disease continues to be unacceptable in many settings. Objective: To analyze the impact of improved knowledge provided by the successive international clinical practice guidelines on reducing diagnostic delay and improving the diagnostic process for European patients with EoE. Methods: Cross-sectional analysis of the EoE CONNECT registry based on clinical practice. Time periods defined by the publication dates of four major sets of guidelines over 10 years were considered. Patients were grouped per time period according to date of symptom onset. Results: Data from 1,132 patients was analyzed and median (IQR) diagnostic delay in the whole series was 2.1 (0.7-6.2) years. This gradually decreased over time with subsequent release of new guidelines (p < 0.001), from 12.7 years up to 2007 to 0.7 years after 2017. The proportion of patients with stricturing of mixed phenotypes at the point of EoE diagnosis also decreased over time (41.3% vs. 16%; p < 0.001), as did EREFS scores. The fibrotic sub-score decreased from a median (IQR) of 2 (1-2) to 0 (0-1) when patients whose symptoms started up to 2007 and after 2017 were compared (p < 0.001). In parallel, symptoms measured with the Dysphagia Symptoms Score reduced significantly when patients with symptoms starting before 2007 and after 2012 were compared. A reduction in the number of endoscopies patients underwent before the one that achieved an EoE diagnosis, and the use of allergy testing as part of the diagnostic workout of EoE, also reduced significantly over time (p = 0.010 and p < 0.001, respectively). Conclusion: The diagnostic work-up of EoE patients improved substantially over time at the European sites contributing to EoE CONNECT, with a dramatic reduction in diagnostic delay. |
| Databáze: | OpenAIRE |
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