Do non-targeted gastric biopsies affect the management of patients, and can a simple protocol and education reduce the rate?

Frontline Gastroenterology
Victoria GibsonNick P Thompson

Abstract

To determine whether development of localised protocol could reduce the number of non-targeted gastric biopsies taken at endoscopy, without risking harm from non-detection of malignant conditions. Retrospective analysis of patient records over a 3-month period in 2013, repeated in 2015 following intervention. Two UK teaching hospitals. Patient record data on indication for endoscopy, endoscopy findings, histopathology results and patient outcome. Guidance on upper gastrointestinal biopsy in the form of a new trust-wide protocol, as well as lecture-based education. Rates of non-targeted and targeted biopsies before and after intervention, and differences between grade of endoscopist. Between 2013 and 2015, there was a 36% reduction in non-targeted biopsies (10.4% vs 6.7%, p=0.001), predominantly within registrar and nurse endoscopist groups, with reduction in non-targeted biopsies of 9.5% and 64%, respectively. Percentage of targeted biopsies remained relatively static, 7.9% and 8.2%. In 2013, 92% of non-targeted biopsies had no management change based on histology; in 2015 this was 90%. Of patients with alteration to management, only 0.4% and 0.7% were due to malignancy, in known high-risk patients. Reduction in non-targeted bi...Continue Reading

References

Feb 14, 1998·Journal of Clinical Pathology·B CadmanJ I Wyatt
Sep 29, 2004·Endoscopy·S YalamarthiC D Auld
Sep 26, 2013·The Cochrane Database of Systematic Reviews·Anthony O'ConnorColm A O'Moráin
Jul 9, 2014·Current Opinion in Gastroenterology·Veroushka Ballester, Marcia Cruz-Correa
Aug 15, 2014·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Jun Liang TehJimmy Bok-Yan So
Aug 2, 2016·Canadian Journal of Gastroenterology & Hepatology·Anouar TeriakyBrian Yan

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Citations

Feb 28, 2018·Frontline Gastroenterology·Anton V Emmanuel
Mar 28, 2020·United European Gastroenterology Journal

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