Diagnostic yield of upper endoscopy according to appropriateness: A systematic review

Despite some official guidelines are available, a substantial rate of inappropriateness for upper gastrointestinal (UGI) endoscopies has been reported. This study aimed to estimate the inappropriate rate of UGI in different countries, also including the diagnostic yield. A systematic review of studi...

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Bibliographic Details
Published in:Digestive and liver disease 2019-03, Vol.51 (3), p.335-339
Main Authors: Zullo, Angelo, Manta, Raffaele, De Francesco, Vincenzo, Fiorini, Giulia, Hassan, Cesare, Vaira, Dino
Format: Article
Language:English
Subjects:
Appropriateness
Cancer
Diagnostic yield
Relevant finding
Upper GI endoscopy
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Summary:Despite some official guidelines are available, a substantial rate of inappropriateness for upper gastrointestinal (UGI) endoscopies has been reported. This study aimed to estimate the inappropriate rate of UGI in different countries, also including the diagnostic yield. A systematic review of studies on UGI endoscopy appropriateness was performed by adopting official guidelines as reference standard. Diagnostic yield of relevant endoscopic findings and cancers was compared between appropriate and inappropriate procedures. The Odd Ratio (OR) values and the Number-Needed-to-Scope (NNS) were calculated. Data of 23 studies with a total of 53,392 patients were included. UGI indications were overall inappropriate in 21.7% (95% CI = 21.4–22.1) of the patients. The inappropriateness rate significantly (P 
ISSN:1590-8658
1878-3562
DOI:10.1016/j.dld.2018.11.029