title: Variation in inflammatory bowel disease care among saudi pediatric gastroenterologists.
abstract: OBJECTIVE
  Although international guidelines in inflammatory bowel disease (IBD) management are currently available, variations in IBD care still exist. The aim of this study was to determine the extent of the variation in IBD care among Saudi pediatric gastroenterologists.
  
  
  METHODS
  A cross-sectional survey was conducted among all pediatric gastroenterologists who were members of the Saudi Society of Pediatric Gastroenterology, Hepatology, and Nutrition (SASPGHAN) from August 2015 to December 2015. The questionnaire included items on demographic characteristics and utilization of different diagnostic and therapeutic interventions in IBD care.
  
  
  RESULTS
  Of the 45 registered pediatric gastroenterologists surveyed, 37 (82%) returned the survey from 20 centers across the country; 75.7% were practicing in tertiary care centers. There was a considerable variation in the use of different diagnostic tests during the initial evaluation of the disease. Utilization of calprotectin assays, magnetic resonance imaging enterography, and bone densitometry seemed to vary the most between physicians practicing at tertiary and secondary care centers. There were statistically significant differences in the prescription of biological therapy between the two groups.
  
  
  CONCLUSIONS
  We found a considerable variation in the use of different diagnostic and therapeutic interventions in the management of pediatric IBD patients. Such variations could lead to unintended differences in patient outcomes. Implementation of the available evidence-based guidelines may limit such variations and ultimately could improve the quality of IBD care provided.
authors.affiliation: Gastroenterology Unit, Pediatric Department, King Khalid University Hospital; Prince Abdullah Bin Khalid Celiac Disease Research Chair, College of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Ahmed A
authors.initials: AA
authors.lastname: Al-Sarkhy
mesh_terms: D003430:Cross-Sectional Studies; D019317:Evidence-Based Medicine; D005260:Female; D000072102:Gastroenterologists / Q000592:standards*; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis* / Q000628:therapy*; D008297:Male; D010372:Pediatrics; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012529:Saudi Arabia; D011795:Surveys and Questionnaires; D062606:Tertiary Care Centers / Q000706:statistics & numerical data