986 Mir-29b and Mir-503 Differentially Modulate Intestinal Epithelial Barrier Function by Altering Claudin-1 Expression

Abstract

G A A b st ra ct s uncertain (e.g. ulcer disease, esophagitis). Analyzing data through 2009, we then identified individuals within the cohort who had a repeat EGD within three years of their index EGD. Results: Approximately 11.6% of Medicare beneficiaries in the sample underwent an index EGD between 2004 and 2006 (n = 108,785). Of these, 33.4% (n = 36,331) had at least one repeat EGD within three years of their index EGD. Most likely to undergo a repeat EGD were patients with an index diagnosis of varices (61.0%) and Barrett's esophagus (58.5%). However, the absolute contribution of these two diagnoses to all repeat exams was very small (0.5% and 6.5%). Index diagnoses suggesting that a repeat EGD was routinely indicated comprised only 22.6% of repeat exams. In contrast, index diagnoses that did not suggest the need for a repeat EGD comprised 59.9% of repeat exams. Common diagnostic categories in this latter group included gastritis/duodenitis (21.0% of repeat exams), abdominal pain/dyspepsia (9.6%), or nonspecific EGD findings (9.2%). Conclusion: One in three Medicare beneficiaries undergoing an EGD had a repeat EGD within three years. Most of these repeated exams were performed for patients with a diagnosis at index endoscopy that does not imply that a repeat exam would be necessary. These findings raise questions about whether EGD is overutilized, particularly in terms of repetitive exams.