Gastroesophageal reflux disease: a need for guidelines for the primary care physician.
BACKGROUND
Guidelines are important for keeping family physicians informed of the constant developments in many fields of medicine.


OBJECTIVE
To compare the knowledge of gastroenterologists and family physicians regarding the diagnosis and treatment of gastroesophageal reflux disease in order to determine the need for expert guidelines.


METHODS
A 25 item questionnaire on the definition, diagnosis and treatment of GERD was presented to 35 gastroenterologists and 35 family physicians. Each item was rated on a four point scale from 1 = highly recommended to 4 = not recommended. A voting system was used for each group on separate occasions. The proportions of correct answers according to the level of recommendation were compared between the groups.


RESULTS
The groups' responses agreed on only 4 of the 25 items; differences between the remaining 21 were all statistically significant. For 14 items, 70% of the gastroenterologists chose the grade 1 recommendation, whereas more than 70% of the family physicians chose mostly grade 2.


CONCLUSIONS
The gap in knowledge on gastroesophageal reflux disease between gastroenterologists and family physicians is significant and may have a profound impact on diagnosis and treatment. Clear and accurate guidelines may improve patient evaluation in the community.
Niv
Yaron
Y
Department of Gastroenterology, Rabin Medical Center (Beilinson Campus), Petah Tiqva, Israel. yniv@clalit.org.il
Birkenfield
Shlomo
S
D000328:Adult; D002648:Child; D002983:Clinical Competence / Q000592:standards*; D005762:Gastroenterology / Q000592:standards*; D005764:Gastroesophageal Reflux / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007223:Infant; D010821:Physicians, Family / Q000592:standards*; D017410:Practice Guidelines as Topic / Q000592:standards*; D010818:Practice Patterns, Physicians' / Q000592:standards