The Diagnostic Yield of Upper Endoscopy Procedures in Children- is It Cost Effective?

Overview

Journal Curr Gastroenterol Rep

Specialty Gastroenterology

Date 2014 Mar 29

PMID 24676532

Citations 5

Authors

Yoram Elitsur

Affiliations

Soon will be listed here.

Abstract

Upper endoscopy is an invaluable tool for the diagnosis and treatment of various gastrointestinal symptoms in children. Over the years, the number of endoscopic procedures performed in different medical centers has increased considerably and the cost associated with the procedure has become unsustainable. Recently, the US government has investigated this topic and has suggested steps to reduce the cost and use of endoscopic procedures in the adult population, changes that have not been accepted favorably by the American Gastroenterology Associations (AGA). In the present report, we evaluate the diagnostic yield of the procedure in children and suggest steps to reduce the annual number of upper endoscopic procedures in children. The diagnostic yield and the cost-effectiveness of the procedure are also discussed.

Citing Articles

Which Alarm Symptoms Are Associated With Abnormal Gastrointestinal Endoscopy Among Thai Children?.

Wongteerasut A Pediatr Gastroenterol Hepatol Nutr. 2024; 27(2):113-124.

PMID: 38510584 PMC: 10948965. DOI: 10.5223/pghn.2024.27.2.113.

The utility and safety of paediatric endoscopy in a district general hospital in Southeast England.

Shrestha S, Gowda R, Race H, Khan S, Bhaduri B Eur J Pediatr. 2022; 181(5):1959-1965.

PMID: 35091800 PMC: 8797371. DOI: 10.1007/s00431-022-04393-z.

Pediatric Gastrointestinal Endoscopy: Diagnostic Yield and Appropriateness of Referral Based on Clinical Presentation: A Pilot Study.

Fachler T, Shteyer E, Orlanski Meyer E, Shemasna I, Lev Tzion R, Rachman Y Front Pediatr. 2021; 9:607418.

PMID: 34778118 PMC: 8586696. DOI: 10.3389/fped.2021.607418.

Diagnostic Yield of Endoscopic Procedures in Children: Experience of a Portuguese Center.

Silva S, Silva C, Espinheira M, Pinto Pais I, Trindade E, Amil Dias J GE Port J Gastroenterol. 2020; 27(6):404-409.

PMID: 33251289 PMC: 7670335. DOI: 10.1159/000507207.

Gastroscopy in pediatric surgery: indications, complications, outcomes, and ethical aspects.

Roth L, Salo M, Hambraeus M, Stenstrom P, Arnbjornsson E Gastroenterol Res Pract. 2015; 2015:820340.

PMID: 25883646 PMC: 4389833. DOI: 10.1155/2015/820340.

References

Betalli P, Falchetti D, Giuliani S, Pane A, DallOglio L, De Angelis G . Caustic ingestion in children: is endoscopy always indicated? The results of an Italian multicenter observational study. Gastrointest Endosc. 2008; 68(3):434-9. DOI: 10.1016/j.gie.2008.02.016. View

Allen J . The value of colonoscopy. Gastroenterology. 2014; 146(2):573-5. DOI: 10.1053/j.gastro.2013.12.001. View

Petersdorf R . Editorial: Internal medicine 1976: consequences of subspecialization and technology. Ann Intern Med. 1976; 84(1):92-4. DOI: 10.7326/0003-4819-84-1-92. View

Elitsur Y, Dementieva Y, Rewalt M, Lawrence Z . Helicobacter pylori infection rate decreases in symptomatic children: a retrospective analysis of 13 years (1993-2005) from a gastroenterology clinic in West Virginia. J Clin Gastroenterol. 2008; 43(2):147-51. DOI: 10.1097/MCG.0b013e318157e4e7. View

Peery A, Dellon E, Lund J, Crockett S, Mcgowan C, Bulsiewicz W . Burden of gastrointestinal disease in the United States: 2012 update. Gastroenterology. 2012; 143(5):1179-1187.e3. PMC: 3480553. DOI: 10.1053/j.gastro.2012.08.002. View

Cohen J, Safdi M, Deal S, Baron T, Chak A, Hoffman B . Quality indicators for esophagogastroduodenoscopy. Gastrointest Endosc. 2006; 63(4 Suppl):S10-5. DOI: 10.1016/j.gie.2006.02.018. View

Sonnenberg A, Blum A . The cost of knowing the truth-limitations to a cost-benefit analysis of upper GI endoscopy. J Clin Gastroenterol. 1982; 4(2):109-14. DOI: 10.1097/00004836-198204000-00003. View

Liu H, Waxman D, Main R, Mattke S . Utilization of anesthesia services during outpatient endoscopies and colonoscopies and associated spending in 2003-2009. JAMA. 2012; 307(11):1178-84. DOI: 10.1001/jama.2012.270. View

Puzanovova M, Rudzinski E, Shirkey K, Cherry R, Acra S, Walker L . Sex, psychosocial factors, and reported symptoms influence referral for esophagogastroduodenoscopy and biopsy results in children with chronic abdominal pain. J Pediatr Gastroenterol Nutr. 2008; 47(1):54-60. PMC: 3101503. DOI: 10.1097/MPG.0b013e31815a0a13. View

10.

Chan Y, Goh K . Appropriateness and diagnostic yield of EGD: a prospective study in a large Asian hospital. Gastrointest Endosc. 2004; 59(4):517-24. DOI: 10.1016/s0016-5107(04)00002-1. View

11.

Franciosi J, Fiorino K, Ruchelli E, Shults J, Spergel J, Liacouras C . Changing indications for upper endoscopy in children during a 20-year period. J Pediatr Gastroenterol Nutr. 2010; 51(4):443-7. PMC: 2946469. DOI: 10.1097/MPG.0b013e3181d67bee. View

12.

Alabd Alrazzak B, Husien T, Preston D, Elitsur Y . Upper endoscopy in children: do symptoms predict positive findings?. Clin Pediatr (Phila). 2014; 53(5):474-8. DOI: 10.1177/0009922814528034. View

13.

Rudolph C, Mazur L, Liptak G, Baker R, Boyle J, Colletti R . Guidelines for evaluation and treatment of gastroesophageal reflux in infants and children: recommendations of the North American Society for Pediatric Gastroenterology and Nutrition. J Pediatr Gastroenterol Nutr. 2001; 32 Suppl 2:S1-31. DOI: 10.1097/00005176-200100002-00001. View

14.

Squires Jr R, Colletti R . Indications for pediatric gastrointestinal endoscopy: a medical position statement of the North American Society for Pediatric Gastroenterology and Nutrition. J Pediatr Gastroenterol Nutr. 1996; 23(2):107-10. DOI: 10.1097/00005176-199608000-00002. View

15.

Gonvers J, Burnand B, Froehlich F, Pache I, Thorens J, Fried M . Appropriateness and diagnostic yield of upper gastrointestinal endoscopy in an open-access endoscopy unit. Endoscopy. 1996; 28(8):661-6. DOI: 10.1055/s-2007-1005573. View

16.

Seematter-Bagnoud L, Vader J, Wietlisbach V, Froehlich F, Gonvers J, Burnand B . Overuse and underuse of diagnostic upper gastrointestinal endoscopy in various clinical settings. Int J Qual Health Care. 1999; 11(4):301-8. DOI: 10.1093/intqhc/11.4.301. View

17.

Gilger M . Gastroenterologic endoscopy in children: past, present, and future. Curr Opin Pediatr. 2002; 13(5):429-34. DOI: 10.1097/00008480-200110000-00008. View

18.

Froehlich F, Repond C, Mullhaupt B, Vader J, Burnand B, Schneider C . Is the diagnostic yield of upper GI endoscopy improved by the use of explicit panel-based appropriateness criteria?. Gastrointest Endosc. 2000; 52(3):333-41. DOI: 10.1067/mge.2000.107906. View

19.

Miele E, Giannetti E, Martinelli M, Tramontano A, Greco L, Staiano A . Impact of the Rome II paediatric criteria on the appropriateness of the upper and lower gastrointestinal endoscopy in children. Aliment Pharmacol Ther. 2010; 32(4):582-90. DOI: 10.1111/j.1365-2036.2010.04383.x. View

20.

Thakkar K, El-Serag H, Mattek N, Gilger M . Complications of pediatric EGD: a 4-year experience in PEDS-CORI. Gastrointest Endosc. 2007; 65(2):213-21. DOI: 10.1016/j.gie.2006.03.015. View