Variation in Treatment of Patients With Inflammatory Bowel Diseases at Major Referral Centers in the United States
| Autor: | Bruce E. Sands, Jennifer Kwon, William F. Stenson, Dermot P.B. McGovern, Laura E. Raffals, Ashwin N. Ananthakrishnan, Robert S. Sandler, John H. Kwon, Robert L. Rheaume |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Referral Disease Gastroenterology Inflammatory bowel disease Young Adult Pharmacotherapy Crohn Disease Drug Therapy Internal medicine medicine Humans Immunologic Factors Prospective Studies Prospective cohort study Aged Aged 80 and over Crohn's disease Hepatology business.industry Odds ratio Middle Aged medicine.disease Ulcerative colitis United States Colitis Ulcerative Female Health Services Research business |
| Zdroj: | Clinical Gastroenterology and Hepatology. 13:1197-1200 |
| ISSN: | 1542-3565 |
| DOI: | 10.1016/j.cgh.2014.11.020 |
| Popis: | We performed a prospective study of patients with inflammatory bowel diseases to examine variations in treatment among medical centers. In a prospective cohort study of 1659 patients with Crohn's disease and 946 patients with ulcerative colitis seen at 7 high-volume referral centers, we collected data on demographics, disease characteristics, and medical and surgical treatments. We used logistic regression to determine differences in treatment among centers, controlling for potential confounders. We found significant variations among centers in the treatment of Crohn's disease with immunomodulators (odds ratio [OR], 3.34; 95% confidence interval [CI], 2.09-5.32) but not anti-tumor necrosis factor agents (OR, 1.64; 95% CI, 0.97-2.77). There was less variation in the treatment of ulcerative colitis; we found no difference in use of immunomodulators (OR, 1.83; 95% CI, 1.00-3.36) or anti-tumor necrosis factor therapy (OR, 0.81; 95% CI, 0.40-1.65). The development and implementation of evidence-based standards of care for inflammatory bowel disease may help reduce variation and improve outcomes. |
| Databáze: | OpenAIRE |
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