Prospective study of the clinical impact of EUS.
BACKGROUND
Studies on the clinical impact of EUS are lacking. The aim of this study was to examine the impact of EUS on the management plans by referring doctors and patient outcomes.


METHODS
Consecutive patients undergoing EUS between August 2002 and June 2004 were prospectively studied. Referring doctors were given a pre-EUS questionnaire that asked about provisional diagnosis and management plan. A post-EUS questionnaire was sent 6 weeks after the procedure.


RESULTS
A total of 330 patients were examined, and completed questionnaires were received in 70%. EUS-guided FNA was performed in 69 (30%) patients. EUS resulted in a change in diagnosis and management in 26% and 48% of cases, respectively. Thirty-nine of the latter patients (33%) avoided unnecessary surgery. In 50% of cases, additional investigations were avoided. Doctors reported EUS as very or moderately useful in 210 patients (91%). Doctors of 223 patients (97%) reported that they would use EUS again.


CONCLUSIONS
The use of EUS had a significant clinical impact on patients. EUS resulted in a change of diagnosis in a fourth of patients and a change in management in half of patients studied.
Chong
André K H
AK
Department of Gastroenterology, St. Vincent's Hospital, Melbourne, Victoria, Australia.
Caddy
Grant R
GR
Desmond
Paul V
PV
Chen
Robert Y
RY
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D016009:Chi-Square Distribution; D003937:Diagnosis, Differential; D004067:Digestive System Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D019160:Endosonography / Q000379:methods*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D008479:Mediastinal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000000981:diagnostic imaging* / Q000473:pathology; D011336:Probability; D011446:Prospective Studies; D012017:Referral and Consultation; D018570:Risk Assessment; D012680:Sensitivity and Specificity