Original articleClinical endoscopyThe appropriateness of colonoscopies at a teaching hospital: magnitude, associated factors, and comparison of EPAGE and EPAGE-II criteria
Section snippets
Design
A cross-sectional study was designed.
Setting
The study was performed at the Gastrointestinal Endoscopy Unit of a hospital. Referrals to the Endoscopy Unit are available to gastroenterologists, surgeons, oncologists, internal medicine specialists, and other specialists, but not for general practitioners. The staff of the endoscopic unit consisted of 4 senior endoscopists and several residents, and the annual volume of endoscopies exceeded 6000 explorations, with more than 2500 colonoscopies.
Patients and sample
All patients
Results
During the 4-month study period, 749 consecutive colonoscopies were performed. Of them, 619 (82.6%) were valid for analysis (Fig. 1). The mean age of the patients was 58 years (range 14-91 years), and 46% were women. Gastroenterologists referred two thirds of colonoscopies (n = 409; 66.1%), followed by surgeons (n = 120; 19.4%), general internal medicine physicians (n = 42; 6.8%), oncologists (n = 39; 6.3%), and other specialists (n = 9; 1.5%). Depending on the health care setting of the
Discussion
The results of this study show, first of all, that approximately 1 of every 4 colonoscopies in our hospital were inappropriate with the use of the EPAGE criteria. Inappropriateness decreased to 1 in 6 by using the EPAGE-II criteria, but this figure still implies more than 400 inappropriate colonoscopies each year. The 27% inappropriate use found in our study is an intermediate figure between the 31%17 and 23%18 reported in other Spanish studies with the EPAGE criteria. The 18% by using the
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DISCLOSURE: The authors disclosed no financial relationships relevant to this publication.
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