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Single-Center Review of Appropriateness and Utilization of Upper Endoscopy in Dyspepsia in the United States

BACKGROUND: We compared real-world practice of dyspepsia management to the new American College of Gastroenterology (ACG)/Canadian Association of Gastroenterology (CAG) guidelines 2017. METHODS: We conducted a retrospective, observational study using administrative data to include patients undergoin...

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Detalles Bibliográficos
Autores principales: Gupta, Kamesh, Groudan, Kevin, Jobbins, Kathryn, Hans, Bandhul, Singhania, Rohit
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elmer Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8110238/
https://www.ncbi.nlm.nih.gov/pubmed/34007349
http://dx.doi.org/10.14740/gr1370
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author Gupta, Kamesh
Groudan, Kevin
Jobbins, Kathryn
Hans, Bandhul
Singhania, Rohit
author_facet Gupta, Kamesh
Groudan, Kevin
Jobbins, Kathryn
Hans, Bandhul
Singhania, Rohit
author_sort Gupta, Kamesh
collection PubMed
description BACKGROUND: We compared real-world practice of dyspepsia management to the new American College of Gastroenterology (ACG)/Canadian Association of Gastroenterology (CAG) guidelines 2017. METHODS: We conducted a retrospective, observational study using administrative data to include patients undergoing esophagogastroduodenoscopy (EGD) for dyspepsia. RESULTS: Out of 122 EGDs, only 30 (24.5%) were deemed appropriate per guidelines. Only 13 (14.1%) patients had undergone both Helicobacter pylori (H. pylori) test and treat and adequate proton pump inhibitor (PPI) before undergoing endoscopy. Nineteen (15.5%) patients had alarm symptoms (weight loss, melena and early satiety). Positivity rate of H. pylori was 36.3%, but only half completed treatment. Twenty-six patients (21.3%) had abnormalities on endoscopy, most commonly gastritis. There were no cases of gastric/esophageal cancer. CONCLUSIONS: The rate of inappropriate upper gastrointestinal endoscopy is higher than the existing literature, likely because of the stricter use of EGD in patients < 60 years. Only one in eight patients underwent the recommended workup before undergoing endoscopy.
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spelling pubmed-81102382021-05-17 Single-Center Review of Appropriateness and Utilization of Upper Endoscopy in Dyspepsia in the United States Gupta, Kamesh Groudan, Kevin Jobbins, Kathryn Hans, Bandhul Singhania, Rohit Gastroenterology Res Original Article BACKGROUND: We compared real-world practice of dyspepsia management to the new American College of Gastroenterology (ACG)/Canadian Association of Gastroenterology (CAG) guidelines 2017. METHODS: We conducted a retrospective, observational study using administrative data to include patients undergoing esophagogastroduodenoscopy (EGD) for dyspepsia. RESULTS: Out of 122 EGDs, only 30 (24.5%) were deemed appropriate per guidelines. Only 13 (14.1%) patients had undergone both Helicobacter pylori (H. pylori) test and treat and adequate proton pump inhibitor (PPI) before undergoing endoscopy. Nineteen (15.5%) patients had alarm symptoms (weight loss, melena and early satiety). Positivity rate of H. pylori was 36.3%, but only half completed treatment. Twenty-six patients (21.3%) had abnormalities on endoscopy, most commonly gastritis. There were no cases of gastric/esophageal cancer. CONCLUSIONS: The rate of inappropriate upper gastrointestinal endoscopy is higher than the existing literature, likely because of the stricter use of EGD in patients < 60 years. Only one in eight patients underwent the recommended workup before undergoing endoscopy. Elmer Press 2021-04 2021-04-21 /pmc/articles/PMC8110238/ /pubmed/34007349 http://dx.doi.org/10.14740/gr1370 Text en Copyright 2021, Gupta et al. https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution Non-Commercial 4.0 International License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Gupta, Kamesh
Groudan, Kevin
Jobbins, Kathryn
Hans, Bandhul
Singhania, Rohit
Single-Center Review of Appropriateness and Utilization of Upper Endoscopy in Dyspepsia in the United States
title Single-Center Review of Appropriateness and Utilization of Upper Endoscopy in Dyspepsia in the United States
title_full Single-Center Review of Appropriateness and Utilization of Upper Endoscopy in Dyspepsia in the United States
title_fullStr Single-Center Review of Appropriateness and Utilization of Upper Endoscopy in Dyspepsia in the United States
title_full_unstemmed Single-Center Review of Appropriateness and Utilization of Upper Endoscopy in Dyspepsia in the United States
title_short Single-Center Review of Appropriateness and Utilization of Upper Endoscopy in Dyspepsia in the United States
title_sort single-center review of appropriateness and utilization of upper endoscopy in dyspepsia in the united states
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8110238/
https://www.ncbi.nlm.nih.gov/pubmed/34007349
http://dx.doi.org/10.14740/gr1370
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