No popular authors found.
Ads by Google:

Categories

No categories found.


Get Celiac.com's E-Newsletter





Ads by Google:


Follow / Share


  FOLLOW US:
Twitter Facebook Google Plus Pinterest RSS Podcast Email  Get Email Alerts
SHARE:

Popular Articles

No popular articles found.
Celiac.com Sponsors:

Biopsy Volume Influences Adherence to Celiac Disease Guidelines

Celiac.com 12/04/2013 - About 1 of of 100 Americans has celiac disease, but most cases remain undiagnosed, partly because of failure on the part of physicians to collect at least four specimens during duodenal biopsy, as per current recommendations.

Photo: CC--jovikeA team of researchers recently set out to determine whether physician and practice characteristics are associated with these failures.

The research team included Benjamina Lebwohl, Robert M. Genta, Robert C. Kapel, Daniel Sheehan, Nina S. Lerner, Nina, Peter H. Green, Alfred I. Neugut, and Andrew Rundle.

For their study, the team used a large national pathology database to identify all adult patients who underwent duodenal biopsy during 2006–2009.

They used hierarchical modeling to determine whether procedure volume, the number of gastroenterologists per endoscopy suite, and the number of gastroenterologists per capita of the zip code of the practice were associated with adherence to recommendations.

The team identified 92,580 patients who met their inclusion/exclusion criteria. Patient group was 67% female, averaging 53.5 years of age.

The team received biopsy specimens from 669 gastroenterologists from 200 endoscopy suites, located in 191 zip codes, with a mean of 3.4 gastroenterologists per suite.

Ads by Google:

Multivariate analysis showed that higher procedure volume was associated with decreased adherence to specimen recommendations [odds ratio (OR) for each additional 100 procedures, 0.92; 95% confidence interval (CI), 0.88–0.97; P=0.002].

Gastroenterologists employed in suites with higher numbers of gastroenterologists reported higher levels of adherence (OR for each additional gastroenterologist, 1.08; 95% CI, 1.04–1.13; P<0.001)

However, that was not the case for a higher gastroenterologist density in the zip code of the practice (OR for each additional gastroenterologist per capita, 1.01; 95% CI, 0.99–1.03; P=0.21).

This study suggests that high-volume physicians exhibit lower rates of adherence to biopsy guidelines, possibly because of the additional time required to submit the minimum of four specimens.

In contrast, doctors working in endoscopy suites with high numbers of colleagues showed higher rates of adherence, possibly because of peer education.

Basically, doctors who do large numbers of biopsies are more likely to submit too few samples for accurate analysis, whereas doctors working in close contact with large numbers of peers are more likely to follow current recommendations, and to produce better, more accurate results.

Source:

Celiac.com welcomes your comments below (registration is NOT required).












Related Articles



Comments




Rate this article and leave a comment:
Rating: * Poor Excellent
Your Name *: Email (private) *:




In Celiac.com's Forum Now:


http://hypothyroidmom.com/10-nutrient-deficiencies-every-thyroid-patient-should-have-checked/ Here's an article that explains all the nutrients the thyroid needs to function properly and the consequences to the thyroid if there's a deficiency. Some thyroid problems will correct themse...

Thanks guys! Ill defintley ask about the full thyroid panel. I did antibodies for those thyroid ones a year ago do i have to get that again. Thanks Ennis for those recommandations I will resort back to my food diary!

To add to the good advice above. I think your husband has to take it on himself to communicate with his parents that this is a serious, medically diagnosed condition that their grandson has to live with for the rest of his life. He needs them to back you up, be supportive etc. On no account shoul...

I felt worse after I restarted gluten free diet after my challenge and had a rougher time than I had first time round. So I don't think its unusual. Give your body time to recover. Eat well, lots of good whole foods, maybe a decent multivitamin etc. Go easy on processed gluten-free stuff for awh...

It's a Yorkshire staple! I used to pass their then 'factory' just about every day when I lived in Sheffield, though apparently they've moved now and the Uni are going to turn their old place into a pub. The relish is lovely and marked gluten free and suitable for coeliacs on...