Advanced

The appropriateness of colonoscopy: a multi-center, international, observational study

Harris, JK; Froehlich, F; Gonvers, JJ; Wietlisbach, V; Burnand, B; Vader, J-P; Benoni, Cecilia LU and , (2007) In International Journal for Quality in Health Care 19(3). p.150-157
Abstract
Objective. To examine the appropriateness and necessity of colonoscopy across Europe.



Design. Prospective observational study.



Setting. A total of 21 gastrointestinal centers from 11 countries.



Participants. Consecutive patients referred for colonoscopy at each center.



Intervention. Appropriateness criteria developed by the European Panel on the Appropriateness of Gastrointestinal Endoscopy, using the RAND appropriateness method, were used to assess the appropriateness of colonoscopy.



Main outcome measure. Appropriateness of colonoscopy.



Results. A total of 5213 of 6004 (86.8%) patients who underwent diagnostic colonoscopy and... (More)
Objective. To examine the appropriateness and necessity of colonoscopy across Europe.



Design. Prospective observational study.



Setting. A total of 21 gastrointestinal centers from 11 countries.



Participants. Consecutive patients referred for colonoscopy at each center.



Intervention. Appropriateness criteria developed by the European Panel on the Appropriateness of Gastrointestinal Endoscopy, using the RAND appropriateness method, were used to assess the appropriateness of colonoscopy.



Main outcome measure. Appropriateness of colonoscopy.



Results. A total of 5213 of 6004 (86.8%) patients who underwent diagnostic colonoscopy and had an appropriateness rating were included in this study. According to the criteria, 20, 26, 27, or 27% of colonoscopies were judged to be necessary, appropriate, uncertain, or inappropriate, respectively. Older patients and those with a major illness were more likely to have an appropriate or necessary indication for colonoscopy as compared to healthy patients or patients who were 45–54 years old. As compared to screening patients, patients who underwent colonoscopy for iron-deficiency anemia [OR: 30.84, 95% CI: 19.79–48.06] or change in bowel habits [OR: 3.69, 95% CI: 2.74–4.96] were more likely to have an appropriate or necessary indication, whereas patients who underwent colonoscopy for abdominal pain [OR: 0.64, 95% CI: 0.49–0.83] or chronic diarrhea [OR: 0.54, 95% CI: 0.40–0.75] were less likely to have an appropriate or necessary indication.



Conclusions. This study identified significant proportions of inappropriate colonoscopies. Prospective use of the criteria by physicians referring for or performing colonoscopies may improve appropriateness and quality of care, especially in younger patients and in patients with nonspecific symptoms. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
International Journal for Quality in Health Care
volume
19
issue
3
pages
150 - 157
publisher
Oxford University Press
external identifiers
  • Scopus:34447508027
ISSN
1464-3677
DOI
10.1093/intqhc/mzm008
language
English
LU publication?
yes
id
153e9bb1-94ac-4686-ba36-b76c8f3c900f (old id 1142037)
date added to LUP
2008-08-08 12:54:34
date last changed
2016-12-04 04:43:04
@misc{153e9bb1-94ac-4686-ba36-b76c8f3c900f,
  abstract     = {Objective. To examine the appropriateness and necessity of colonoscopy across Europe.<br/><br>
<br/><br>
Design. Prospective observational study.<br/><br>
<br/><br>
Setting. A total of 21 gastrointestinal centers from 11 countries.<br/><br>
<br/><br>
Participants. Consecutive patients referred for colonoscopy at each center.<br/><br>
<br/><br>
Intervention. Appropriateness criteria developed by the European Panel on the Appropriateness of Gastrointestinal Endoscopy, using the RAND appropriateness method, were used to assess the appropriateness of colonoscopy.<br/><br>
<br/><br>
Main outcome measure. Appropriateness of colonoscopy.<br/><br>
<br/><br>
Results. A total of 5213 of 6004 (86.8%) patients who underwent diagnostic colonoscopy and had an appropriateness rating were included in this study. According to the criteria, 20, 26, 27, or 27% of colonoscopies were judged to be necessary, appropriate, uncertain, or inappropriate, respectively. Older patients and those with a major illness were more likely to have an appropriate or necessary indication for colonoscopy as compared to healthy patients or patients who were 45–54 years old. As compared to screening patients, patients who underwent colonoscopy for iron-deficiency anemia [OR: 30.84, 95% CI: 19.79–48.06] or change in bowel habits [OR: 3.69, 95% CI: 2.74–4.96] were more likely to have an appropriate or necessary indication, whereas patients who underwent colonoscopy for abdominal pain [OR: 0.64, 95% CI: 0.49–0.83] or chronic diarrhea [OR: 0.54, 95% CI: 0.40–0.75] were less likely to have an appropriate or necessary indication.<br/><br>
<br/><br>
Conclusions. This study identified significant proportions of inappropriate colonoscopies. Prospective use of the criteria by physicians referring for or performing colonoscopies may improve appropriateness and quality of care, especially in younger patients and in patients with nonspecific symptoms.},
  author       = {Harris, JK and Froehlich, F and Gonvers, JJ and Wietlisbach, V and Burnand, B and Vader, J-P and Benoni, Cecilia and , },
  issn         = {1464-3677},
  language     = {eng},
  number       = {3},
  pages        = {150--157},
  publisher    = {ARRAY(0xb1e8430)},
  series       = {International Journal for Quality in Health Care},
  title        = {The appropriateness of colonoscopy: a multi-center, international, observational study},
  url          = {http://dx.doi.org/10.1093/intqhc/mzm008},
  volume       = {19},
  year         = {2007},
}