NICE referral guidelines: Impact on Upper GI Endoscopy Practice in patients < 55 years
Muhammad Ahmed Saifullah, E Myers, Ahmad Hasif bin Ab Razak, Amad U.H Bhatti, Israr Un Nabi
Department of Gastroenterology, University Hospital Kerry, Tralee.
Endoscopy demand is growing year on year. It is important that available resources are utilized appropriately. Adherence to referral guidelines for upper GI Endoscopy are important in ensuring best utilization of capacity.
To study the impact of implementing NICE referral guidelines for upper GI endoscopy in patients < 55 years of age in University Hospital Kerry.
1970 patients who underwent OGD between Jan-2021 and Dec 2021 were reviewed. Data was collected using Unisoft GI reporting tool. Patients who were < 55 years old were identified. 853 patients in this group were included in study. Patients' referrals were categorized as indicated or not indicated on the basis of the NICE referral guidelines standards.
Out of 853 patients less than 55 years of age, 501 (58.7%) were females and 352 (41.3%) were males. 269 (31.4%) OGDs were indicated as per NICE guidelines and 584 (68.6%) were not indicated. There was only one malignancy (gastric cancer) detected in the indicated group. In the non-indicated group 15 (2.5%) patients had Barrette’s oesophagus, 2 (0.3%) had duodenal ulcers and 5 (0.8%) had gastric ulcers. Hence, only 4% of non-indicated endoscopies yielded significant positive findings.
Our study showed that by implementing NICE guidelines for UGI endoscopic referrals in patients < 55 years of age, more than half 584 (68.6%) of the procedures could have avoided without missing malignancies.