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Appropriateness of colonoscopy in a University Hospital

An open access endoscopy system allows for the direct scheduling of endoscopies by non-gastroenterologist physicians without prior gastroenterology consultation. The aim of our study was to examine our practice of open access endoscopy by evaluating the appropriateness of referrals for colonoscopy a...

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Main Authors: Tan, Yen Mei, Goh, Khean Lee
Format: Article
Language:English
Published: Malaysian Medical Association 2004
Subjects:
R Medicine
Online Access:http://eprints.um.edu.my/24580/1/Colonoscopy.pdf
http://eprints.um.edu.my/24580/
http://www.e-mjm.org/2004/v59n1/Colonoscopy.pdf
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spelling my.um.eprints.245802021-03-22T01:23:27Z http://eprints.um.edu.my/24580/ Appropriateness of colonoscopy in a University Hospital Tan, Yen Mei Goh, Khean Lee R Medicine An open access endoscopy system allows for the direct scheduling of endoscopies by non-gastroenterologist physicians without prior gastroenterology consultation. The aim of our study was to examine our practice of open access endoscopy by evaluating the appropriateness of referrals for colonoscopy and to determine whether there were differences depending on the specialty of the referring clinician. The indication for colonoscopy was assessed in 499 consecutive outpatients referred for colonoscopy at University Hospital, Kuala Lumpur over a 12-month period. The American Society of Gastrointestinal Endoscopy (ASGE) guidelines were used to determine the appropriateness of referrals. 80.6% of colonoscopies requested by the gastroenterologist were performed for accepted indications compared to 50.6% of referrals by the primary care physician (p<0.001) and 67.0% of referrals by the surgeon (p=0.006). The rate of colonoscopies generally not indicated was 2.1% for the gastroenterologist, 25.0% for the internist (p=0.002) and 7.5% for the surgeon (p=0.04). The rate of indications not listed in the ASGE guidelines was significantly lower for requests made by gastroenterologists (17.3%) than those requested by primary care physicians (44.2%; p<0.001). Patients who have had prior consultation with the gastroenterologist were significantly more likely to undergo colonoscopy for appropriate indications than among patients who were referred through an open access system. The rate of inappropriate indications for colonoscopy was also significantly lower when the gastroenterologist made the referral. A substantial proportion of colonoscopies (25.4%) was performed for indications not listed in the ASGE guidelines. Malaysian Medical Association 2004 Article PeerReviewed text en http://eprints.um.edu.my/24580/1/Colonoscopy.pdf Tan, Yen Mei and Goh, Khean Lee (2004) Appropriateness of colonoscopy in a University Hospital. Medical Journal of Malaysia, 59 (1). pp. 34-38. ISSN 0300-5283 http://www.e-mjm.org/2004/v59n1/Colonoscopy.pdf
institution Universiti Malaya
building UM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Malaya
content_source UM Research Repository
url_provider http://eprints.um.edu.my/
language English
topic R Medicine
spellingShingle R Medicine
Tan, Yen Mei
Goh, Khean Lee
Appropriateness of colonoscopy in a University Hospital
description An open access endoscopy system allows for the direct scheduling of endoscopies by non-gastroenterologist physicians without prior gastroenterology consultation. The aim of our study was to examine our practice of open access endoscopy by evaluating the appropriateness of referrals for colonoscopy and to determine whether there were differences depending on the specialty of the referring clinician. The indication for colonoscopy was assessed in 499 consecutive outpatients referred for colonoscopy at University Hospital, Kuala Lumpur over a 12-month period. The American Society of Gastrointestinal Endoscopy (ASGE) guidelines were used to determine the appropriateness of referrals. 80.6% of colonoscopies requested by the gastroenterologist were performed for accepted indications compared to 50.6% of referrals by the primary care physician (p<0.001) and 67.0% of referrals by the surgeon (p=0.006). The rate of colonoscopies generally not indicated was 2.1% for the gastroenterologist, 25.0% for the internist (p=0.002) and 7.5% for the surgeon (p=0.04). The rate of indications not listed in the ASGE guidelines was significantly lower for requests made by gastroenterologists (17.3%) than those requested by primary care physicians (44.2%; p<0.001). Patients who have had prior consultation with the gastroenterologist were significantly more likely to undergo colonoscopy for appropriate indications than among patients who were referred through an open access system. The rate of inappropriate indications for colonoscopy was also significantly lower when the gastroenterologist made the referral. A substantial proportion of colonoscopies (25.4%) was performed for indications not listed in the ASGE guidelines.
format Article
author Tan, Yen Mei
Goh, Khean Lee
author_facet Tan, Yen Mei
Goh, Khean Lee
author_sort Tan, Yen Mei
title Appropriateness of colonoscopy in a University Hospital
title_short Appropriateness of colonoscopy in a University Hospital
title_full Appropriateness of colonoscopy in a University Hospital
title_fullStr Appropriateness of colonoscopy in a University Hospital
title_full_unstemmed Appropriateness of colonoscopy in a University Hospital
title_sort appropriateness of colonoscopy in a university hospital
publisher Malaysian Medical Association
publishDate 2004
url http://eprints.um.edu.my/24580/1/Colonoscopy.pdf
http://eprints.um.edu.my/24580/
http://www.e-mjm.org/2004/v59n1/Colonoscopy.pdf
_version_ 1695531091398492160
score 13.211869

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