“Rightsizing” Use of Upper Endoscopy
Authors: Nicholas J. Shaheen
Journal: Annals of Internal Medicine (2014)

Editorials4 February 2014“Rightsizing” Use of Upper EndoscopyNicholas J. Shaheen, MD, MPHNicholas J. Shaheen, MD, MPHFrom Center for Esophageal Diseases and Swallowing, University of North Carolina School of Medicine, Chapel Hill, North Carolina.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M13-2907 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Matching use to need is a vexing problem in medicine. For virtually every expensive medical service studied, some degree of misuse is documented. A common finding is lack of use—when persons should get a service but do not. For example, only about two thirds of persons eligible for colorectal cancer screening receive this service (1).Overuse is less commonly studied (2). Ascertaining the appropriateness of a service may be difficult in the U.S. health care system because most large databases are created to track billing data, not medical information. Such systems often contain insufficient information to allow recognition of an ...References1. National Cancer Institute. Cancer Trends Progress Report-2011/2012. Bethesda, MD: National Institutes of Health; 2012. Google Scholar2. Korenstein D, Falk R, Howell EA, Bishop T, Keyhani S. Overuse of health care services in the United States: an understudied problem. Arch Intern Med. 2012;172:171-8. [PMID: 22271125] CrossrefMedlineGoogle Scholar3. Pohl H, Robertson D, Welch HG. Repeated upper endoscopy in the Medicare population. A retrospective analysis. Ann Intern Med. 2014;160:154-60. LinkGoogle Scholar4. Charles RJ, Chak A, Cooper GS, Wong RC, Sivak MV. Use of open access in GI endoscopy at an academic medical center. Gastrointest Endosc. 1999;50:480-5. [PMID: 10502167] CrossrefMedlineGoogle Scholar5. Trevisani L, Sartori S, Gilli G, Chiamenti CM, Gaudenzi P, Alvisi V, et al. Appropriateness of upper gastrointestinal endoscopy: a hospital-based study. Dig Dis Sci. 2001;46:2695-9. [PMID: 11768262] CrossrefMedlineGoogle Scholar6. Rossi A, Bersani G, Ricci G, Defabritiis G, Pollino V, Suzzi A, et al. ASGE guidelines for the appropriate use of upper endoscopy: association with endoscopic findings. Gastrointest Endosc. 2002;56:714-9. [PMID: 12397281] CrossrefMedlineGoogle Scholar7. Peery AF, Dellon ES, Lund J, Crockett SD, McGowan CE, Bulsiewicz WJ, et al. Burden of gastrointestinal disease in the United States: 2012 update. Gastroenterology. 2012;143:1179-87. [PMID: 22885331] CrossrefMedlineGoogle Scholar8. Rubenstein JH, Saini SD, Kuhn L, McMahon L, Sharma P, Pardi DS, et al. Influence of malpractice history on the practice of screening and surveillance for Barrett's esophagus. Am J Gastroenterol. 2008;103:842-9. [PMID: 18076733] CrossrefMedlineGoogle Scholar9. Shaheen NJ, Green B, Medapalli RK, Mitchell KL, Wei JT, Schmitz SM, et al. The perception of cancer risk in patients with prevalent Barrett's esophagus enrolled in an endoscopic surveillance program. Gastroenterology. 2005;129:429-36. [PMID: 16083700] CrossrefMedlineGoogle Scholar10. Shaheen NJ, Weinberg DS, Denberg TD, Chou R, Qaseem A, Shekelle P; Clinical Guidelines Committee of the American College of Physicians. Upper endoscopy for gastroesophageal reflux disease: best practice advice from the clinical guidelines committee of the American College of Physicians. Ann Intern Med. 2012;157:808-16. [PMID: 23208168] LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Center for Esophageal Diseases and Swallowing, University of North Carolina School of Medicine, Chapel Hill, North Carolina.Disclosures: None disclosed. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M13-2907.Corresponding Author: Nicholas J. Shaheen, MD, MPH, Center for Esophageal Diseases and Swallowing, University of North Carolina School of Medicine, CB#7080, Chapel Hill, NC 27599-7080; e-mail, [email protected]unc.edu. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoRepeated Upper Endoscopy in the Medicare Population Heiko Pohl , Douglas Robertson , and H. Gilbert Welch Repeated Upper Endoscopy in the Medicare Population Heiko Pohl , Douglas Robertson , and H. Gilbert Welch Metrics Cited byIs Complete Endoscopic Resection Still a Viable Option for Barrett’s-Related Dysplasia and Neoplasia? 4 February 2014Volume 160, Issue 3Page: 205-206KeywordsDysphagiaEndoscopyEsophagusGastroesophageal reflux diseaseHealth careHealth information technologyMedicarePerceptionWeight loss ePublished: 4 February 2014 Issue Published: 4 February 2014 Copyright & PermissionsCopyright © 2014 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...