"Appropriateness of colonoscopy according to EPAGE II in a low resource setting: a cross sectional study from Sri Lanka".

BMC Gastroenterology
Yasara SamarakoonSumudu Hewage

Abstract

Due to finite resources, the clinical decision to subject a patient to colonoscopy needs to be based on the evidence, regardless of its availability, affordability and safety. This study assessed the appropriateness of colonoscopies conducted in selected study settings in Sri Lanka. In the absence of local guidelines, audit was based on European Panel on Appropriateness of Gastrointestinal Endoscopy II (EPAGE II) criteria. This cross-sectional study assessed consecutive patients who underwent colonoscopy between June to August 2015 at four main hospitals in Sri Lanka. Interviewer administered questionnaire and secondary data were collected by trained health staff. Indications were assessed according to EPAGE II criteria. Out of 325 patients, male female proportions were 57.2 and 42.8%. Mean (SD) age was 54.9 (12.1) years. Colonoscopies were appropriate in 61.2% (95% CI 55.8-66.3), uncertain in 28.6% (95% CI 23.9-33.7) and inappropriate in 10.2% (95% CI 7.3-13.9). Colonoscopy to evaluate abdominal pain has highest percentage of inappropriateness of 10.0%. However, 9.5% of these colonoscopies revealed Colo-Rectal Cancer (CRC), reflecting differences in the profile of local CRC patients. Colonoscopies with appropriate or uncertain...Continue Reading

References

May 31, 2006·Gastrointestinal Endoscopy·Bernard BurnandJean-Jacques Gonvers
Mar 10, 2007·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·J K HarrisJ-P Vader
Mar 13, 2009·Endoscopy·S Schusselé FilliettazUNKNOWN EPAGE II Study Group
Jul 17, 2010·Gastroenterología y hepatología·Silvia CarriónJaume Boix
Feb 17, 2015·World Journal of Gastrointestinal Endoscopy·Antonio Z Gimeno-García, Enrique Quintero

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