Korean J Gastrointest Endosc.  2009 Jun;38(6):332-338.

The Appropriateness of Colonoscopy Indication and the Diagnostic Yield of Colonoscopy

• Lee CY
• Lee CH
• Kim YH
• Lee JW
• Kim SY
• Park DI
• Sung IK

Abstract

BACKGROUND/AIMS: We wanted to evaluate if the guidelines for appropriately performing colonoscopy by the American Society for Gastrointestinal Endoscopy (ASGE) yield good diagnostic efficacy, and we wanted to assess the appropriateness of referrals.
METHODS
A total of 2,412 consecutive patients (1,605 men and 807 women) who were undergoing colonoscopy from September 2006 to February 2007 were prospectively enrolled in the study. The diagnostic yield was defined as the percentage of relevant colonic pathologies of the total number of performed colonoscopies. The 2000 ASGE guidelines were used to assess the appropriateness of the indications for the procedure.
RESULTS
The large majority (64.2%) of patients had colonoscopy for an indication that was considered 'generally indicated', while the procedure was considered 'generally not indicated' for 22.4% of the patients. The diagnostic yield of colonoscopy was significantly higher for the appropriate colonoscopies (59.1%) than for the inappropriate colonoscopies (23.2%). On the multivariable analysis, the diagnostic yield was independently associated with the appropriateness of the indication that was "generally indicated" (odds ratio=9.5) and with the referrals by a gastroenterologist (odds ratio=1.7).
CONCLUSIONS
The ASGE guidelines have shown a good diagnostic yield. Further steps are required to update and standardize the guidelines to increase the diagnostic yield.

Keyword

Colonoscopy; Indication; Diagnostic yield; Appropriateness

MeSH Terms

Colon
Colonoscopy
Endoscopy, Gastrointestinal
Humans
Male
Prospective Studies
Referral and Consultation