Why Don't Gastroenterologists Follow Colon Polyp Surveillance Guidelines? Results of a National Survey
Why Don't Gastroenterologists Follow Colon Polyp Surveillance Guidelines? Results of a National Survey
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DOI：
10.1097/mcg.0b013e31818242ad
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发表时间：
2009-07-01
影响因子：
2.9
通讯作者：
Schoenfeld, Philip
中科院分区：
文献类型：
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作者：
Saini, Sameer D.;Nayak, Rahul S.;Schoenfeld, Philip
目标：衡量胃肠病学家对结肠息肉监测指南的了解和接受程度。背景：胃肠病学家通常比指南建议的时间更早进行监测结肠镜检查。缺乏知识可能是一个重要因素，但胃肠病学家也可能只是不同意指南的建议。研究：一项24项多选择调查是从2003年多社会结直肠癌筛查和监测指南发展而来的。这项调查分发给执业胃肠病学家准备在2个主要的国家胃肠病委员会审查课程的胃肠病委员会重新认证考试。对于每个问题，受试者都被给予一个临床场景，并被问到：（1）该场景的指南建议;（2）他们在该场景中的通常做法;以及（3）他们是否明确知道该建议或只是猜测正确答案。如果被调查者知道的建议，但在他们的惯常做法不同，这被认为是不同意的recommendation.Results：调查完成了57.1%（116/203）的胃肠病学家准备2004年重新认证。78%的人表示他们熟悉2003年的指南，但只有57%的人表示指南在他们的实践中“非常有影响力”。许多人没有正确回答增生性息肉（12%），2个小腺瘤（36%），3个小腺瘤（49%）和腺瘤伴高度异型增生（41%）的建议间隔时间问题。胃肠病学家谁知道指南的建议，高达76%不同意的建议，并选择进行监测早于recommended.Conclusions：虽然许多胃肠病学家缺乏知识的指南建议结肠息肉监测，即使是那些谁知道的建议往往忽视他们，并进行监测结肠镜检查早于推荐。
Goals: To measure knowledge and acceptance of colon polyp surveillance guidelines among gastroenterologists.Background: Gastroenterologists often perform surveillance colonoscopy sooner than recommended by guidelines. Lack of knowledge may be an important factor, but gastroenterologists Could also simply disagree with guideline recommendations.Study: A 24-item multiple-choice survey was developed from the 2003 multisociety colorectal cancer screening and surveillance guideline. The survey was distributed to practicing gastroenterologists preparing for the gastroenterology board recertification examination at 2 major national gastroenterology board review courses. For each question, subjects were given a clinical scenario and asked: (1) the guideline recommendation for the scenario; (2) their usual practice in the scenario; and, (3) if they definitely knew the recommendation or were simply guessing at the correct answer. If a respondent knew the recommendation but differed in their usual practice, this was considered disagreement with the recommendation.Results: The Survey was completed by 57.1% (116/203) of gastroenterologists preparing for 2004 recertification. Seventy-eight percent reported that they were familiar with the 2003 guideline, though only 57% reported that guidelines were "very influential" in their practice. Many did not correctly answer questions on the recommended interval for hyperplastic polyps (12%), 2 small adenomas (36%), 3 small adenomas (49%), and adenoma with high-grade dysplasia (41%). Of gastroenterologists who knew the guideline recommendations, up to 76% disagreed with the recommendations and chose to perform surveillance sooner than recommended.Conclusions: Though many gastroenterologists lack knowledge about guideline recommendations for colon polyp surveillance, even those who know the recommendations often ignore them and perform surveillance colonoscopy sooner than recommended.