诊断性上消化道内镜合理使用的合格标准:适用性和有效性

来源 :世界核心医学期刊文摘(胃肠病学分册) | 被引量 : 0次 | 上传用户:daxiang11
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Appropriate indication for upper gastrointestinal endoscopy (UGE) may be facilitated by referring to qualifying criteria such as those devised by the European Panel (EPAGE) and French Experts (ANAES). This prospective study evaluates the applicability and efficacy of these criteria in clinical practice. Patients and methods -A total of 522 patients was included (55%inpatients, 57%male, mean age 55 years). Appropriateness of referral was evaluated using EPAGE and ANAES criteria sets by a single independent expert. Results -EPAGE criteria were applicable in 71%of cases. Indications for UGE were appropriate, inappropriate and uncertain in 62%, 27%and 11%respectively; 74%, 16%and 10%of clinically significant lesions detected by UGE were disclosed in patients having appropriate, inappropriate and uncertain indications respectively. ANAES criteria were applicable in 81%of cases. Indications for UGE were appropriate in 74%, inappropriate in 26%; 76%and 24%of clinically significant lesions detected by UGE were disclosed in patients having appropriate and inappropriate indications respectively. Whatever the criteria set used, all cancers and most of the severe lesions were observed in patients with appropriate indications: those patients were more often in-patients and were significantly older than patients belonging to the inappropriate group. Conclusion -Reference to EPAGE and ANAES qualifying criteria facilitates patient selection for UGE. Final decision must however rely upon practitioner advice. ANAES criteria are significantly more often applicable than EPAGE ones. However EPAGE referential when applicable is more predictive of the UGE findings. Appropriate indication for upper gastrointestinal endoscopy (UGE) may be facilitated by referring to qualifying criteria such as those who devised by the European Panel (EPAGE) and French Experts (ANAES). This prospective study evaluates the applicability and efficacy of these criteria in clinical practice. Patients and methods - A total of 522 patients was included (55% inpatients, 57% male, mean age 55 years). Appropriateness of referral was evaluated using EPAGE and ANAES criteria sets by a single independent expert. Results -EPAGE criteria were applicable in 71% of cases. Indications for UGE were appropriate, inappropriate and uncertain in 62%, 27% and 11% respectively; 74%, 16% and 10% of clinically significant lesions detected by UGE were disclosed in patients with appropriate, inappropriate and uncertain in Indications for UGE were appropriate in 74%, inappropriate in 26%; 76% and 24% of clinically significant lesions det Whatever the criteria set used, all cancers and most of the severe lesions were observed in patients with appropriate indications: those patients were more often in-patients and were significantly older than patients Conclusion to Reference to EPAGE and ANAES qualifying criteria facilitates patient selection for UGE. Final decision must sometimes rely upon upon practitioner advice. ANAES criteria are significantly more often applicable than EPAGES ones. However, EPAGE referential when applicable is more predictive of the UGE findings.
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