| 대장내시경 적응증의 적절성 및 진단율과의 연관성 조사 |
| 이춘영ㆍ이충현ㆍ김영호ㆍ이종우ㆍ김신연*ㆍ박동일*ㆍ성인경† |
| 성균관대학교 의과대학 삼성서울병원 내과학교실, *성균관대학교 의과대학 강북삼성병원 내과학교실, †건국대학교 의과대학 건국대학교병원 내과학교실 |
| The Appropriateness of Colonoscopy Indication and the Diagnostic Yield of Colonoscopy |
| Choon Young Lee, M.D., Choong Hyeon Lee, M.D., Young Ho Kim, M.D., Jong Woo Lee, M.D., Shin Yeon Kim, M.D.*, Dong Il Park, M.D.* and In Kyung Sung, M.D.† |
| Division of Gastroenterology, Department of Internal Medicine, Samsung Medical Center, *Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, †Konkuk University Hospital, Konkuk University School of Medicine, Seoul, Korea |
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| Abstract |
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Background/Aims:
We wanted to evaluate if the guidelines for appropriately performing colonoscopy by the American Society for Gastrointestinal Endoscopy (ASGE) yield good diagnostic efficacy, and we wanted to assess the appropriateness of referrals.
Methods:
A total of 2,412 consecutive patients (1,605 men and 807 women) who were undergoing colonoscopy from September 2006 to February 2007 were prospectively enrolled in the study. The diagnostic yield was defined as the percentage of relevant colonic pathologies of the total number of performed colonoscopies. The 2000 ASGE guidelines were used to assess the appropriateness of the indications for the procedure.
Results:
The large majority (64.2%) of patients had colonoscopy for an indication that was considered 'generally indicated', while the procedure was considered 'generally not indicated' for 22.4% of the patients. The diagnostic yield of colonoscopy was significantly higher for the appropriate colonoscopies (59.1%) than for the inappropriate colonoscopies (23.2%). On the multivariable analysis, the diagnostic yield was independently associated with the appropriateness of the indication that was "generally indicated" (odds ratio=9.5) and with the referrals by a gastroenterologist (odds ratio=1.7).
Conclusions:
The ASGE guidelines have shown a good diagnostic yield. Further steps are required to update and standardize the guidelines to increase the diagnostic yield. (Korean J Gastrointest Endosc 2009;38:332-338) |
| Key Words:
Colonoscopy, Indication, Diagnostic yield, Appropriateness |
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