Variation in small bowel biopsy performance among diverse endoscopy settings: results from a national endoscopic database

The American Journal of Gastroenterology
G C HarewoodDavid A Lieberman

Abstract

The diagnostic gold standard for celiac sprue requires performance of small bowel biopsy to identify characteristic mucosal changes. The current biopsy practice among endoscopists for celiac sprue is unknown. The CORI (Clinical Outcomes Research Initiative) national endoscopic database was analyzed to determine the rate of small bowel biopsy in patients undergoing EGD for the evaluation of anemia, iron deficiency without anemia, weight loss, and diarrhea. Between January 2000 and September 2003, 3,992 patients underwent EGD for the evaluation of anemia, iron deficiency, weight loss, and diarrhea with normal EGD findings. Overall, 438 patients (11%) underwent small bowel biopsy. Small bowel biopsy performance varied with procedure indication: anemia 10%, iron deficiency 7%, weight loss 6%, and diarrhea 19%, p < 0.0001. Biopsy rates declined with advancing patient age; 12% (<50 yr), 12% (50-69 yr), and 9% (> or =70 yr), p= 0.002, and also differed with patient race (12%, Whites vs 8%, non-Whites), p= 0.0007. Biopsy performance varied among endoscopy sites: community (9%), academic (13%), and VAMC (15%), p < 0.0001. Multivariate analysis identified age > or =70 yr (OR: 0.52, p= 0.0007), non-White race (OR: 0.60, p= 0.0007) and an ...Continue Reading

References

Jan 22, 1994·Lancet·C CatassiP L Giorgi
Jan 1, 1994·Gut·G L Hankey, G K Holmes
May 1, 1996·Acta Paediatrica. Supplement·A Fasano
Jul 1, 1996·Journal of Clinical Gastroenterology·W Dickey, J B McConnell
Sep 23, 1997·Scandinavian Journal of Gastroenterology·G R CorazzaG Gasbarrini
May 19, 1998·European Journal of Gastroenterology & Hepatology·S D JohnstonA H Love
Feb 19, 2000·Annals of Medicine·P Collin
Mar 4, 2000·Gastroenterology·D A LiebermanM Helfand
Jun 7, 2000·Gastrointestinal Endoscopy·M T BardellaD Conte
Jun 7, 2000·Gastrointestinal Endoscopy·V H ShahP H Green
Feb 24, 2001·The American Journal of Gastroenterology· Green PHRA I Neugut
Mar 29, 2001·Digestive Diseases and Sciences·A DaheleS Ghosh
Apr 26, 2001·Journal of Pediatric Gastroenterology and Nutrition·D MarinelloG Oderda
Oct 30, 2001·Digestive Diseases and Sciences·C CiacciG Mazzacca
Jan 18, 2002·The New England Journal of Medicine·Richard J Farrell, Ciarán P Kelly
May 11, 2002·The American Journal of Gastroenterology·Amy S OxentenkoJeffrey A Alexander
Mar 20, 2003·Digestive Diseases and Sciences·Winson LoPeter H R Green
Jul 3, 2003·Gastrointestinal Endoscopy·Peter H R Green, Joseph A Murray
Mar 16, 2004·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Joseph A MurrayL Joseph Melton

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Citations

Sep 16, 2006·Blood·Thorvardur R HalfdanarsonJoseph A Murray
Jan 31, 2013·Digestive Diseases and Sciences·Benjamin LebwohlPeter H R Green
Dec 16, 2016·Journal of Pediatric Gastroenterology and Nutrition·Josephine SheuJeannie S Huang
Apr 29, 2006·Gastrointestinal Endoscopy Clinics of North America·Peter H R Green, Moshe Rubin
Mar 16, 2007·The American Journal of Gastroenterology·Carlo CatassiAlessio Fasano
Jan 9, 2007·European Journal of Gastroenterology & Hepatology·Can GonenOmur Gonen
Jun 27, 2007·The American Journal of Gastroenterology·Peter H R Green
Aug 12, 2005·Current Opinion in Gastroenterology·Susie K Lee, Peter H R Green
Feb 26, 2015·Journal of Pediatric Gastroenterology and Nutrition·Deborah L Preston, Yoram Elitsur
Aug 29, 2006·World Journal of Gastroenterology : WJG·S RiestraL Rodrigo
Oct 25, 2006·Scandinavian Journal of Gastroenterology·Veronica OjettiAntonio Gasbarrini
Jun 24, 2017·Journal of Pediatric Gastroenterology and Nutrition·Thomas WallachNorelle R Reilly
Mar 13, 2010·Southern Medical Journal·Rizwan KibriaKanan Sharma
Sep 3, 2013·European Journal of Gastroenterology & Hepatology·Benjamin LebwohlAndrew Rundle
Feb 19, 2021·Scandinavian Journal of Gastroenterology·Claire L Jansson-Knodell, William R Kessler
Jun 27, 2012·Gastrointestinal Endoscopy·Benjamin LebwohlPeter H R Green
Aug 24, 2020·Gastroenterology·Don C RockeyDenise Kalmaz

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