The EPAGE guidelines are not an effective strategy for managing colonoscopies during the COVID-19 pandemic.
EPAGE no es una estrategia eficaz para la gestión de colonoscopias durante la pandemia por COVID-19.
Adult
Age Factors
Aged
Analysis of Variance
COVID-19
/ epidemiology
Colonoscopy
/ standards
Colorectal Neoplasms
/ diagnosis
Endoscopy, Gastrointestinal
/ standards
Female
Gastroenterology
/ standards
Humans
Intestinal Diseases
/ diagnosis
Male
Middle Aged
Occult Blood
Pandemics
Practice Guidelines as Topic
Predictive Value of Tests
Prospective Studies
Risk Factors
Sex Factors
Societies, Medical
Adecuación
Colonoscopia
Colonoscopy
EPAGE
EPAGE guidelines
Immunologic faecal occult blood test
Prioritization
Priorización
Suitability
Test de sangre oculta en heces
Journal
Gastroenterologia y hepatologia
ISSN: 0210-5705
Titre abrégé: Gastroenterol Hepatol
Pays: Spain
ID NLM: 8406671
Informations de publication
Date de publication:
Jan 2022
Jan 2022
Historique:
received:
03
07
2020
revised:
15
11
2020
accepted:
28
11
2020
pubmed:
6
2
2021
medline:
30
12
2021
entrez:
5
2
2021
Statut:
ppublish
Résumé
The pandemic caused by the SARS-CoV-2 virus has had a serious impact on the functioning of gastrointestinal endoscopy Units. The Asociación Española de Gastroenterología (AEG) and the Sociedad Española de Endoscopia Digestiva (SEED) have proposed the EPAGE guidelines for managing postponed colonoscopies. To evaluate the EPAGE guidelines as a management tool compared to the immunologic faecal occult blood test (iFOBT) and compared to risk score (RS) that combines age, sex and the iFOBT for the detection of colorectal cancer (CRC) and significant bowel disease (SBD). A prospective, single-centre study enrolling 743 symptomatic patients referred for a diagnostic colonoscopy. Each order was classified according to the EPAGE guidelines as appropriate, indeterminate or inappropriate. Patients underwent an iFOBT and had their RS calculated. The iFOBT (p<0.001), but not the EPAGE guidelines (p = 0.742), was an independent predictive factor of risk of CRC. The ROC AUCs for the EPAGE guidelines, the iFOBT and the RS were 0.61 (95% CI 0.49-0.75), 0.95 (0.93-0.97) and 0.90 (0.87-0.93) for CRC, and 0.55 (0.49-0.61), 0.75 (0.69-0.813) and 0.78 (0.73-0.83) for SBD, respectively. The numbers of colonoscopies needed to detect a case of CRC and a case of SBD were 38 and seven for the EPAGE guidelines, seven and two for the iFOBT, and 19 and four for a RS ≥5 points, respectively. The EPAGE guidelines, unlike the iFOBT, is not suitable for screening candidate patients for a diagnostic colonoscopy to detect CRC. The iFOBT, in combination with age and sex, is the most suitable strategy for managing demand for endoscopy in a restricted-access situation.
Identifiants
pubmed: 33545240
pii: S0210-5705(21)00009-1
doi: 10.1016/j.gastrohep.2020.11.020
pmc: PMC8054645
pii:
doi:
Types de publication
Journal Article
Langues
eng
spa
Sous-ensembles de citation
IM
Pagination
9-17Informations de copyright
Copyright © 2021 Elsevier España, S.L.U. All rights reserved.
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