title: Diagnostic workup of paediatric patients with inflammatory bowel disease in Europe: results of a 5-year audit of the EUROKIDS registry.
abstract: OBJECTIVE
  In 2005, the Inflammatory Bowel Disease (IBD) Working Group of the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition published consensus guidelines on the diagnostic workup of paediatric IBD, the Porto criteria. According to these guidelines, children suspected of having IBD should undergo an oesophagogastroduodenoscopy (OGD), ileocolonoscopy, and (except in cases of definitive ulcerative colitis) adequate imaging of the small bowel. To audit and evaluate the diagnostic workup of paediatric patients with IBD in Europe, the Working Group created EUROKIDS, a prospective, Web-based registry of newly diagnosed paediatric patients with IBD.
  
  
  METHODS
  Patients with IBD (ages 0-18 years) were registered in 44 centres in 18 countries. Data on diagnostic workup were analysed according to the year of diagnosis, type of IBD, and centre size. Diagnostic yield of OGD and ileal intubation were evaluated.
  
  
  RESULTS
  Between 2004 and 2009, 2087 newly diagnosed patients were correctly registered. Both OGD and ileocolonoscopy had been performed in 64% of all of the patients and increased significantly from year 1 (52 %) to 5 (71%, P  <  0.001). Small-bowel follow-through use decreased during the years (year 1 n = 213, year 5 n = 108; P < 0.001), whereas magnetic resonance imaging use increased (year 1 n  = 25, year 5 n  = 171; P < 0.001). Patients diagnosed as having Crohn disease (CD, 59%) and ulcerative colitis (58%) were more likely to have had a complete diagnostic workup than patients diagnosed as having IBD unclassified (45%). In CD, the diagnostic yield of OGD was 7.5% and the yield of ileal intubation was 13%.
  
  
  CONCLUSIONS
  The quality of diagnostic workup in paediatric patients with IBD increased steadily between 2004 and 2009. Small-bowel imaging by magnetic resonance imaging superseded the use of small-bowel follow-through. OGD and ileal intubation contributed to a definitive diagnosis of CD.
authors.affiliation: Department of Paediatric Gastroenterology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands.
authors.forename: Charlotte I
authors.initials: CI
authors.lastname: de Bie
authors.forename: Stephan
authors.initials: S
authors.lastname: Buderus
authors.forename: Bhupinder K
authors.initials: BK
authors.lastname: Sandhu
authors.forename: Lissy
authors.initials: L
authors.lastname: de Ridder
authors.forename: Anders
authors.initials: A
authors.lastname: Paerregaard
authors.forename: Gabor
authors.initials: G
authors.lastname: Veres
authors.forename: Jorge Amil
authors.initials: JA
authors.lastname: Dias
authors.forename: Johanna C
authors.initials: JC
authors.lastname: Escher
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003093:Colitis, Ulcerative / Q000473:pathology; D003424:Crohn Disease / Q000473:pathology; D016099:Endoscopy, Gastrointestinal / Q000706:statistics & numerical data; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D015212:Inflammatory Bowel Diseases / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy; D020407:Internet; D007421:Intestine, Small / Q000473:pathology*; D007441:Intubation, Gastrointestinal; D009682:Magnetic Resonance Spectroscopy / Q000706:statistics & numerical data; D008297:Male; D008485:Medical Audit; D017410:Practice Guidelines as Topic; D058996:Quality Improvement; D012042:Registries