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Endoscopy 1999; 31(8): 579-595
DOI: 10.1055/s-1999-62
Special Topic
Georg Thieme Verlag Stuttgart ·New York

1. Appropriateness of Gastroscopy: Dyspepsia [1]

F. Froehlich * , M. Bochud ** , J.-J. Gonvers * , R. W. Dubois *** , J.-P. Vader ** , V. Wietlisbach ** , B. Burnand **
  • * Policlinique Médicale Universitaire, Lausanne, Switzerland
  • ** Institut Universitaire de Médecine Sociale et Préventive, Lausanne, Switzerland
  • *** Protocare Sciences, Santa Monica, USA
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Publication History

Publication Date:
31 December 1999 (online)

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Introduction

Dyspepsia is a very common set of clinical symptoms. Clear-cut scientific evidence of the effectiveness of diagnostic schemes is unavailable for most clinical situations related to dyspepsia. For this and other reasons, practice patterns vary widely. The development of explicit detailed criteria of appropriateness of use of endoscopy is an attempt to produce best available evidence (based on a validated panel process and expert judgment) where better evidence is lacking, with the aim to assist the clinician in daily decision making.

In November 1998, a multidisciplinary European expert panel convened in Lausanne, Switzerland, to discuss and develop criteria for the appropriate use of gastrointestinal endoscopy, a widely-used procedure, regarded as highly accurate and safe. The RAND appropriateness method was chosen for this purpose, because it allows the development of appropriateness criteria based on published evidence and supplemented by explicit expert opinion. A detailed description of the RAND appropriateness method, including the literature search process [1], and of the whole process, as well as the global results of the panel [2], are published as separate articles in this issue of the Journal. The literature review was based on a systematic search of Medline, Embase and the Cochrane Library conducted up to the end of 1997 and completed with some key articles published in 1998. Updating and revision of the literature review is currently ongoing.

This article presents a literature review on dyspepsia, that was provided to the panelists to study and comment prior to the panel meeting to support their ratings of appropriateness of use of upper gastrointestinal endoscopy. This article furthermore presents an overview of the main panel results related to dyspepsia and a summary of published evidence and panel-based appropriateness criteria.

1 The European Panel on Appropriateness of Gastrointestinal Endoscopy (EPAGE, Lausanne, Switzerland)

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1 The European Panel on Appropriateness of Gastrointestinal Endoscopy (EPAGE, Lausanne, Switzerland)

Florian FroehlichMD PD 

Policlinique Médicale Universitaire

Rue César-Roux 19

CH-1005 Lausanne

Switzerland

Phone: +41-32-466 29 55

Email: florian.froehlich@bluewin.ch

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