Appropirateness of upper gastrointestinal endoscopy referrals from primary health care

ABSTRACT

Open-access endoscopy is defined as [the provision of a diagnostic endoscopic procedure by direct request of a general practitioner without prior hospital consultation] [1]. Although open access is needed to meet the increasing demand for endoscopy service, studies suggest there is a link between such a system and inappropriate use of esophagogastroduodenoscopy [EGD], particularly in primary care. [2-8] To ensure the appropriateness of EGD, the American Society for Gastrointestinal Endoscopy [ASGE] has developed criteria to promote safe and responsible endoscopic practice[9]. In Saudi Arabia, gastrointestinal symptoms are common, with normal endoscopic findings ranging from 23.5% to 29%, [10-14] but there is little, if any, application of standard criteria to judge the use of endoscopy. This study examined the appropriateness of EGD referrals from primary health care [PHC] and the association between appropriate use and the presence of significant lesions detected by endoscopy using standard criteria developed by the ASGE