Abstract
Upper Gastrointestinal Endoscopy is a frequently advised investigation for upper abdominal symptoms. Studies have questioned the appropriateness of indications for upper gastrointestinal endoscopy and have shown that inappropriate indications range from 5% to 49%. The unnecessary upper gastrointestinal endoscopy expose patients to the risk. The number of upper gastrointestinal endoscopy is rising in our region and we assume so is the number of unnecessary upper gastrointestinal endoscopy. With an aim to find out the appropriateness of the indications of upper gastrointestinal endoscopy and compare its association with positive findings, we conducted a cross-sectional descriptive study. All patients undergoing diagnostic upper gastrointestinal endoscopy during study period were included in the study. Appropriateness of indications for upper gastrointestinal endoscopy was defined as per American Society for Gastrointestinal Endoscopy criteria as "appropriate" and "inappropriate". Upper gastrointestinal endoscopy findings were classified as "significant" and "insignificant" based on endoscopy findings. The extent of this association between appropriateness of indications and upper gastrointestinal endoscopy findings was expressed as the odds ratio of finding a relevant diagnosis in patients with an ''appropriate'' indication compared with those with an 'inappropriate'' indication. Seventy-nine patients were included in the study. Fifty- two (65.8%) of the indications were considered appropriate as per American Society for Gastrointestinal Endoscopy guidelines. Thirty-three (63.5%) of the appropriate indications has clinically significant finding as compared to seven (25.9%) of inappropriate indication with an odds ratio of 4.962 (95% CI:1.773 - 13.890, P=0.002) which is statistically significant. Appropriate indications have significantly higher rates of clinically significant findings. Use of guidelines may decrease the number of unnecessary procedures.
Highlights
Upper Gastrointestinal Endoscopy is a frequently advised investigation for upper abdominal symptoms
Thirtythree (63.5%) of the appropriate indications has clinically significant finding as compared to seven (25.9%) of inappropriate indication with an odds ratio of 4.962 which is statistically significant
Studies have questioned the appropriateness of indications for Upper Gastrointestinal Endoscopy (UGIE) and have shown that inappropriate indications range from 5% to 49%
Summary
Upper Gastrointestinal Endoscopy is a frequently advised investigation for upper abdominal symptoms. Studies have questioned the appropriateness of indications for UGIE and have shown that inappropriate indications range from 5% to 49%.1–3. These unnecessary UGIE expose patients to the risks of the procedure and results in increased waiting period and increased health care expenses. The American Society for Gastrointestinal Endoscopy (ASGE) guidelines have been used to define the appropriateness of the Correspondence: Dr Tanka Prasad Bohara, Department of Bohara Appropriateness of Indications of Upper Gastrointestinal Endoscopy and its Association With Positive Finding indications.[4,5,6,7,8,9] The number of UGIE is rising in our region and we assume so is the number of unnecessary UGIE. To the best of our knowledge, there are no studies regarding the appropriateness of UGIE indication in our country
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