Portal de investigação
Systematic review with meta-analysis: the appropriateness of colonoscopy increases the probability of relevant findings and cancer while reducing unnecessary exams
Autores da FMUP
Participantes de fora da FMUP
- Frazzoni, L
- La Marca, M
- Radaelli, F
- Spada, C
- Laterza, L
- Zagari, RM
- Bazzoli, F
- Hassan, C
- Frazzoni, M
- Fuccio, L
Unidades de investigação
Abstract
Background Colonoscopy is frequently performed in industrialised countries. Inappropriate colonoscopies might lead to unnecessary exams, increasing risks and costs. Aim To estimate the impact of colonoscopy appropriateness in terms of gain in additional diagnoses and sparing of unnecessary exams. Methods Systematic review including studies reporting the prevalence of relevant findings, colorectal cancer (CRC) and inflammatory bowel disease (IBD) according to colonoscopy appropriateness as defined by the American Society for Gastrointestinal Endoscopy and European Panel on Appropriateness of Gastrointestinal Endoscopy. Results Twenty-one studies with 19,822 patients were included. Colonoscopy was appropriate in 15,162 (71%, CI 64%-78%). Appropriateness significantly increased the probability of relevant findings (34% vs. 18%; RR 1.81, CI 1.53-2.14), CRC (7% vs. 2%; RR 3.62, CI 2.44-5.37) and IBD (6% vs. 4%; RR 1.86, CI 1.09-3.19). Appropriateness had sensitivity 88% (CI 85%-91%), 97% (CI 93%-98%) and 89% (CI 80%-94%), and specificity 24% (CI 20%-29%), 22% (CI 18%-26%) and 24% (CI 20%-28%) for relevant findings, CRC and IBD, respectively. On average, performing colonoscopy with appropriate indication would find 15 (CI 10-21) more relevant findings, five (CI 3-9) more CRCs and three (CI 1-9) more diagnoses of IBD per 100 patients, and save 24 (CI 20-29), 22 (CI 18-26) and 24 (CI 20-28) examinations per 100 patients for relevant findings, CRC and IBD, respectively. Conclusions Appropriateness affects the diagnostic yield of colonoscopy for CRC, IBD and relevant findings. Appropriateness criteria are useful, although integrated with clinical evaluation of the patient.
© 2020 John Wiley & Sons Ltd.
Dados da publicação
- ISSN/ISSNe:
- 0269-2813, 1365-2036
- Tipo:
- Review
- Páginas:
- 22-32
- DOI:
- 10.1111/apt.16144
- Link para outro recurso:
- www.scopus.com
ALIMENTARY PHARMACOLOGY & THERAPEUTICS Wiley-Blackwell Publishing Ltd
Citações Recebidas na Web of Science: 9
Citações Recebidas na Scopus: 12
Documentos
- Não há documentos
Filiações
Keywords
- GASTROINTESTINAL ENDOSCOPY; DIAGNOSTIC YIELD; EUROPEAN PANEL; UNITED-STATES; GUIDELINES; CRITERIA; PERFORMANCE; PATTERNS; SERVICES; ENHANCE
Proyectos asociados
Effectiveness of endoscopic resection of colonic lesions > 20mm
Investigador Principal: Mário Jorge Dinis Ribeiro
Estudo Clínico Académico (Colonic lesions) . 2020
Citar a publicação
Frazzoni L,La Marca M,Radaelli F,Spada C,Laterza L,Zagari RM,Bazzoli F,Hassan C,Frazzoni M,Dinis M,Fuccio L. Systematic review with meta-analysis: the appropriateness of colonoscopy increases the probability of relevant findings and cancer while reducing unnecessary exams. Aliment. Pharmacol. Ther. 2021. 53(1):p. 22-32. IF:9,524. (1).
