التفاصيل البيبلوغرافية
| العنوان: |
The professional background of a referring physician predicts the diagnostic yield of small bowel capsule endoscopy in suspected small bowel bleeding |
| المؤلفون: |
Compare, Debora, Sgamato, Costantino, Rocco, Alba, Coccoli, Pietro, Donnarumma, Durante, Marchitto, Stefano Andrea, Cinque, Sofia, Palmieri, Pietro, Nardone, Gerardo |
| المصدر: |
Endoscopy International Open ; volume 12, issue 02, page E282-E290 ; ISSN 2364-3722 2196-9736 |
| بيانات النشر: |
Georg Thieme Verlag KG |
| سنة النشر: |
2024 |
| الوصف: |
Background and study aims The diagnostic yield of small-bowel capsule endoscopy (SBCE) in suspected small bowel bleeding (SSBB) is highly variable. Different reimbursement systems and equipment costs also limit SBCE use in clinical practice. Thus, minimizing non-diagnostic procedures is advisable. This study aimed to assess the SBCE diagnostic yield and identify factors predicting diagnostic findings in a cohort of patients with SSBB. Patients and methods In this retrospective cohort study, we analyzed the medical records of patients who consecutively underwent SBCE for SSBB over 9 years. By logistic regression, we identified covariates predicting diagnostic findings at SBCE. Finally, we performed a post-hoc cost analysis based on previous gastroenterologist or endoscopist consultations versus direct SBCE ordering by other specialists. Results The final analysis included 584 patients. Most SBCEs were ordered by a gastroenterologist or endoscopist (74%). The number of SBCEs without any finding was significantly lower in the gastroenterologist/endoscopist group P<0.001). The SBCE diagnostic yield ordered by a gastroenterologist or endoscopist was significantly higher than that by other specialists (63% vs 52%, odds ratio [OR] 1.57; 95% confidence interval [CI] 1.07–2.26, P=0.019). At multivariate analysis, older age (OR 1.7, 95%CI 1.2–2.4, P=0.005), anemia (OR 4.9, 95%CI 1.9–12, P=0.001), small bowel transit time (OR 1, 95%CI 1–1.02, P=0.039), and referring physician (OR 1.8, 95%CI 1.1–2.7, P=0.003) independently predicted diagnostic findings. Implementing prior gastroenterologist or endoscopist referral vs direct SBCE ordering would reduce medical expenditures by 16%. Conclusions The professional background of referring physicians significantly improves the diagnostic yield of SBCE and contributes to controlling public health costs. |
| نوع الوثيقة: |
article in journal/newspaper |
| اللغة: |
English |
| DOI: |
10.1055/a-2251-3285 |
| DOI: |
10.1055/a-2251-3285.pdf |
| الإتاحة: |
https://doi.org/10.1055/a-2251-3285Test |
| حقوق: |
https://creativecommons.org/licenses/by-nc-nd/4.0Test/ |
| رقم الانضمام: |
edsbas.1A250FA1 |
| قاعدة البيانات: |
BASE |
