title: Multicenter Study Assessing Physician Recommendations Regarding the Continuation of Aspirin and/or NSAIDs Prior to Gastrointestinal Endoscopy.
abstract: BACKGROUND
  In 2009 the American Society for Gastrointestinal Endoscopy (ASGE) guidelines advised that both aspirin and NSAIDs be continued prior to low-risk gastrointestinal endoscopic procedures. We sought to determine physician knowledge regarding these guidelines.
  
  
  METHODS
  A survey questionnaire was developed based on the ASGE guidelines. Physicians were queried about whether they would continue/stop aspirin in a patient with cardiac disease and in a patient taking NSAIDs for arthritis whether they would continue/stop NSAIDs prior to endoscopy. The survey was administered at three academic medical centers. Demographic information: level of training, board certification, teaching trainees, percentage of time in clinical practice, year of medical school graduation, and location of medical school were all reviewed. The primary outcome was number of questions answered correctly and predictors of correct responses.
  
  
  RESULTS
  The survey was administered to 941 participants with 12 declining to participate, while 80% (740/929) of the subjects completed the survey; 20% (150/740) respondents answered both questions correctly and 42% (310/740) answered one question correctly. There was no significant difference between institutions (p = 0.6) or between attendings and trainees (p = 0.75). Multivariate predictors of correct answers were self-reported familiarity with the guideline (-0.029; 95% CI -0.003 to -0.056, p < 0.031), level of training (0.050; 95% CI 0.012-0.088, p = 0.010), and specialty (0.108; 95% CI 0.058-0.159, p < 0.0001). Finally, there was an inverse, linear relationship between postgraduate year and percent questions correct.
  
  
  CONCLUSIONS
  Physician knowledge of guidelines regarding the use of aspirin and NSAIDs prior to endoscopy is suboptimal. Interventions are necessary to improve knowledge of the current pre-procedure guidelines.
authors.affiliation: Division of Gastroenterology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis Street 8E Gastroenterology, Boston, MA, 02215, USA. jfeuerst@bidmc.harvard.edu.
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Feuerstein
authors.affiliation: Division of Gastroenterology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis Street 8E Gastroenterology, Boston, MA, 02215, USA. Etapper@bidmc.harvard.edu.
authors.forename: Elliot B
authors.initials: EB
authors.lastname: Tapper
authors.affiliation: Department of Medicine, University of Massachusetts Memorial Medical Center, University of Massachusetts Medical School, Worcester, MA, USA. Edward.Belkin@umassmemorial.org.
authors.forename: Edward
authors.initials: E
authors.lastname: Belkin
authors.affiliation: Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. jlewando@bidmc.harvard.edu.
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Lewandowski
authors.affiliation: Division of Gastroenterology, Department of Medicine, University of Washington, University of Washington School of Medicine, Seattle, WA, USA. anand.singla@gmail.com.|Department of Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA. anand.singla@gmail.com.
authors.forename: Anand
authors.initials: A
authors.lastname: Singla
authors.affiliation: Division of Gastroenterology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis Street 8E Gastroenterology, Boston, MA, 02215, USA. Ssethi@bidmc.harvard.edu.
authors.forename: Saurabh
authors.initials: S
authors.lastname: Sethi
authors.affiliation: Division of Gastroenterology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis Street 8E Gastroenterology, Boston, MA, 02215, USA. ssheth@bidmc.harvard.edu.
authors.forename: Sunil G
authors.initials: SG
authors.lastname: Sheth
authors.affiliation: Division of Gastroenterology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis Street 8E Gastroenterology, Boston, MA, 02215, USA. Msawhney@bidmc.harvard.edu.
authors.forename: Mandeep
authors.initials: M
authors.lastname: Sawheny
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage* / Q000009:adverse effects; D001241:Aspirin / Q000008:administration & dosage* / Q000009:adverse effects; D002983:Clinical Competence / Q000592:standards; D004334:Drug Administration Schedule; D004503:Education, Medical, Graduate / Q000592:standards; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects / Q000592:standards*; D019983:Guideline Adherence / Q000592:standards; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008404:Massachusetts; D008875:Middle Aged; D017410:Practice Guidelines as Topic / Q000592:standards; D010818:Practice Patterns, Physicians' / Q000592:standards*; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin
keywords: Aspirin; Endoscopy; Guidelines; NSAIDs; Quality