Knowledge of Appropriate Indications for EUS by Physicians In-Training and Practice across Specialties

Abstract

Purpose: EUS has evolved as a useful imaging and interventional modality for work-up and treatment of a variety of lesions. Appropriate referral for EUS requires knowledge, which may be variable, about EUS by non-gastroenterologists. We assessed the knowledge of indications and the utility of EUS among participants at a regional internal medicine (IM) update conference after a lecture about EUS and among physicians working at a large multispecialty academic institution with an active program in EUS. Methods: A survey was done using a modification of previously published questionnaire. This questionnaire was distributed to all the participating members at a regional IM conference who attended a lecture about EUS and to faculty and residents in IM, gastroenterology (GI) and surgery at University of Texas Medical Branch (Galveston, TX). The correct answers were then compared among various groups of responders and with respect to organ systems. Results: Table 1 compares the results of the participants in training and practice across specialties about indications of EUS for different organ systems. Gastroenterologists were more likely to be correct than non-GI physicians (p < 0.001). There were no significant differences between the mean scores of faculty vs. residents, surgeons vs. non-surgeons, referring vs. non-referring physicians and participants vs. non-participants. Respondents were more likely to identify an appropriate upper GI indication and less likely to identify an appropriate colo-rectal indication (p < 0.001). Conclusions: Although EUS has a number of diagnostic and therapeutic clinical applications, non-GI physicians appear to have a reasonable knowledge about its indications. A single lecture on EUS indications can serve as an effective tool in educating practicing non-GI physicians who may be out-of-training for many years and may not have been exposed to this technology in training. Knowledge about lower GI indications for EUS is less when compared to upper GI indications.Table 1: No Caption available.