Patterns of endoscopy use in the United States.
OBJECTIVE
The aim of this study was to use a large national endoscopic database to determine why routine endoscopy is performed in diverse practice settings.


METHODS
A computerized endoscopic report generator was developed and disseminated to gastrointestinal (GI) specialists in diverse practice settings. After reports were generated, a data file was transmitted electronically to a central databank, where data were merged from multiple sites for analysis.


RESULTS
From April 1, 1997, to October 28, 1998, 276 physicians in 31 practice sites in 21 states provided 18,444 esophagogastroduodenoscopy (EGD) reports, 20,748 colonoscopy reports, and 9767 flexible sigmoidoscopy reports to the central databank. EGD was most commonly performed to evaluate dyspepsia and/or abdominal pain (23.7%), dysphagia (20%), symptoms of gastroesophageal reflux without dysphagia (17%), and suspected upper GI bleeding (16.3%). Colonoscopy was most often performed for surveillance of prior neoplasia (24%) and evaluation of hematochezia (19%) or positive fecal occult blood test (15%). Flexible sigmoidoscopy was most commonly performed for routine screening (40%) and evaluation of hematochezia (22%). There were significant differences between academic and nonacademic sites.


CONCLUSIONS
The endoscopic database can be an important resource for future research in endoscopy by documenting current practice patterns and changes in practice over time.
Lieberman
D A
DA
Division of Gastroenterology, Department of Medicine, Oregon Health Sciences University, Portland, Oregon 97207, USA. lieberma@ohsu.edu
De Garmo
P L
PL
Fleischer
D E
DE
Eisen
G M
GM
Helfand
M
M
D003113:Colonoscopy / Q000706:statistics & numerical data; D019992:Databases as Topic; D004724:Endoscopy / Q000706:statistics & numerical data*; D016145:Endoscopy, Digestive System / Q000706:statistics & numerical data; D004935:Esophageal Diseases / Q000473:pathology; D005767:Gastrointestinal Diseases / Q000473:pathology; D006801:Humans; D010818:Practice Patterns, Physicians'; D012812:Sigmoidoscopy / Q000706:statistics & numerical data; D014481:United States