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Endoscopy 1996; 28(8): 661-666
DOI: 10.1055/s-2007-1005573
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Appropriateness and Diagnostic Yield of Upper Gastrointestinal Endoscopy in an Open-Access Endoscopy Unit

J.-J. Gonvers1 , B. Burnand1 , F. Froehlich1 , I. Pache1 , J. Thorens1 , M. Fried3 , J. Kosecoff4 , J.-P. Vader2 , R.H. Brook5,6
  • 1Division of Gastroenterology, University Medical Outpatient Dept., Lausanne, Switzerland
  • 2Institute of Social and Preventive Medicine, University of Lausanne, Lausanne, Switzerland
  • 3Division of Gastroenterology, University of Zurich, Zurich, Switzerland
  • 4Value Health Sciences, Santa Monica, California, USA
  • 5University of California School of Medicine and School of Public Health, Los Angeles, California, USA
  • 6RAND Corporation, Santa Monica, California, USA
Further Information

Publication History

Publication Date:
17 March 2008 (online)

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See also:

Response to Comments by Minoli and PradaEndoscopy 1997; 29(05): 431-432
DOI: 10.1055/s-2007-1004233

See also:

Comment on Gonvers, “Appropriateness and Diagnostic Yield of Upper Gastrointestinal Endoscopy”Endoscopy 1997; 29(05): 430-431
DOI: 10.1055/s-2007-1004232

Abstract

Background and Study Aims: This prospective study tested the appropriateness of referrals for upper gastrointestinal endoscopy in an open-access endoscopy unit, using the criteria of the American Society for Gastrointestinal Endoscopy. It also examined whether there was any relationship between appropriateness of use and the presence of significant lesions detected by endoscopy.

Methods: Four hundred fifty consecutive upper gastrointestinal endoscopies were studied prospectively. The referral indication was recorded by the endoscopist before the procedure was performed, and was compared with the current criteria of the American Society for Gastrointestinal Endoscopy and with endoscopic findings.

Results: The appropriateness of referral was assessed in 442 consecutive endoscopies. Of these, 252 (57 %) were judged to be appropriate. In 168 (88 %) of the 190 endoscopies rated as inappropriate, the reason was that the patient had not undergone empirical anti-ulcer therapy before endoscopy. The probability of finding a significant lesion did not differ between the endoscopies judged to be appropriate (50 %) and those judged to be inappropriate (46 %)

Conclusions: Upper gastrointestinal endoscopy was frequently used for inappropriate indications. The main reason for inappropriate use was insufficient treatment, or no treatment, of dyspeptic symptoms prior to endoscopy. In this study, the criteria for appropriateness did not predict the probability of finding a significant endoscopic lesion.

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