Effectiveness and safety of esophagogastroduodenoscopy in family practice: experience at a university medical center.
OBJECTIVE
As the use of esophagogastroduodenoscopy (EGD) by family physicians increases, a need exists to further demonstrate the procedure's clinical effectiveness and safety and the general experience of family physicians performing the procedure. This study examines the general experience of a group of family physicians performing EGDs in the university setting.


METHODS
An analysis was done of all patients undergoing EGDs performed by family physicians at a university hospital during a consecutive 27-month period. Demographics, indications, findings, diagnoses, therapy, complications, and biopsies were analyzed. Clinical effectiveness was measured by recording whether an EGD resulted in changes in diagnosis, medical therapy, or clinical management. Endoscopic diagnoses also were correlated with biopsy pathological diagnoses.


RESULTS
During the study period, 188 EGDs were performed. Clinical management of patients was changed in 88.6% of cases. The diagnosis was changed in 81.8% of cases, and drug therapy was changed in 55.7% of cases. Endoscopic impressions were confirmed by biopsy in 93.2% of cases. Procedures were completed in 98.3% of cases with no complications.


CONCLUSIONS
This study demonstrates the clinical effectiveness of EGDs performed by family physicians. The feasibility of family practice endoscopy in the university medical center setting has been demonstrated, and continued benefits from this practice are anticipated.
Pope
J B
JB
Department of Family Medicine, Louisiana State University Medical Center, Shreveport, USA.
Mayeaux
E J
EJ
Harper
M B
MB
D000046:Academic Medical Centers; D001706:Biopsy; D016145:Endoscopy, Digestive System / Q000706:statistics & numerical data; D005194:Family Practice / Q000706:statistics & numerical data; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008145:Louisiana; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies