A53 EVALUATING THE DIAGNOSTIC YIELD OF PATIENTS PRESENTING FOR COLONOSCOPY WITH ISOLATED ABDOMINAL PAIN
Notice bibliographique
Résumé
Colonoscopy is used as a diagnostic and therapeutic procedure to assess patients with lower gastrointestinal disease. Practice guidelines from the American Society of Gastrointestinal Endoscopy (ASGE) outline accepted indications for colonoscopy; however, there is disagreement over there use in patients who present with abdominal pain in the absence of other symptoms. These guidelines state that colonoscopy is generally not indicated for chronic abdominal pain, noting that there are “unusual exceptions in which colonoscopy may be done once to rule out disease, especially if symptoms are unresponsive to therapy”. The diagnostic yield of colonoscopy for the isolated indication of abdominal pain is thought to be low, though few studies have been published that confirm this. While it is generally considered a safe procedure, colonoscopy carries potentially serious risks including perforation, bleeding, discomfort, and issues related to anxiolysis. Furthermore, colonoscopy is a limited resource with multiple firmly established indications. The aim of our study was perform a quality initiative to assess the diagnostic yield of colonoscopy and procedure related complications for the isolated indication of abdominal pain. We performed a retrospective analysis of all patients undergoing colonoscopy in the Central Zone of Nova Scotia Health Authority for the isolated indication of abdominal pain, from April 1, 2015 to March 30, 2016. Data was retrieved from the Clinical Outcomes Research Initiative (CORI) database, including patient demographics, supplemented by information obtained from regional Horizon Patient Folder. The primary outcome was endoscopic findings, and secondary outcome was procedure related complications. In total, 98 participants received a colonoscopy for isolated abdominal pain. Participants had a mean age of 52 years (range 16–84), of which 63.3% were female. Abnormal colonic findings were identified in 48% of colonoscopy reports, with biopsies taken in 56% of cases. Colonic polyps and diverticulosis were each detected in 24.5% of participants and were the most frequent diagnostic findings. Other findings at time of colonoscopy included hemorrhoid (3.1%), malignancy (1.0%), and Crohn’s disease (1.0%). No immediate complications were reported. Over half of the patients underwent a biopsy during the procedure and approximately 1 in 4 patients were found to have polyps. The diagnoses of Crohn’s disease, malignancy and diverticular disease may account for patients’ abdominal pain; however, these finding represented only 27% of our study population. This quality analysis reveals a low diagnostic yield for significant findings that may be attributable to the patients’ abdominal pain at our center. More research is needed to determine what subgroups of patients with abdominal pain may benefit from colonoscopy. None
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,006 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».