TY  - JOUR
  - Breen, M.,Murphy, K. P.,O'Neill, S. B.,O'Donovan, J. P.,McWilliams, S.,Desmond, A. N.,Shanahan, F.,Quigley, E. M.,Maher, M. M.
  - 2014
  - December
  - Eur Radioleur Radiol
  - The utilisation and diagnostic yield of radiological imaging in a specialist functional GI disorder clinic: an 11-year retrospective study
  - Validated
  - ()
  - 24
  - 12
  - 3097
  - 3104
  - OBJECTIVES: The term functional gastrointestinal disorders (FGID) describes various aggregations of chronic gastrointestinal (GI) symptoms not explained by identifiable organic pathology; accordingly, their diagnosis rests on symptom-based criteria and a process of exclusion. Evidence is lacking on the appropriate use of abdominal imaging studies (AIS) in FGIDs. METHODS: We investigated the utilisation of AIS (site, modality, diagnostic yield/significance) at a tertiary FGID clinic over an 11-year period. RESULTS: Of 1,621 patients, 507 (31 %; 67.5 % women, mean age 43.9 +/- 17.37 years) referred from primary care had 997 AIS (1.7 per patient): ultrasonography (US) 36.1 %, fluoroscopy (FLS) 28.8 %, computed tomography (CT) 19.6 %, plain radiography (PR) 13.5 %, nuclear medicine (NM) 1 %). Of the 997 AIS, 55.6 % (554/997) were normal. Of the AIS with positive findings, 9.9 % (62/625) were deemed 'probably significant' and 14.7 % (92/625) 'significant'. Of the CT and FLS studies, 12.3 % and 13.6 %, respectively, yielded 'significant' abnormalities compared to 2.2 % of the US studies and 2.1 % of the PR studies. CT identified five of seven neoplasms, associated with male sex, increasing age and symptom onset after age 50 years. CONCLUSIONS: This study confirmed low use of AIS in tertiary FGID clinics and a high proportion of normal studies. Barium swallow/meal and CT were more likely to identify 'probably significant' or 'significant' findings, including neoplasms. KEY POINTS: * Imaging referral rates from a specialist functional gastrointestinal disorder clinic are low * Despite this, normal studies are still frequent in those who are imaged * Ultrasonography was the most frequent investigation, yet yielded significant findings infrequently * Abdominal radiographs accounted for 13.5 % of investigations yet were normal in 71.8 % * CT and fluoroscopy were more likely to yield positive findings.OBJECTIVES: The term functional gastrointestinal disorders (FGID) describes various aggregations of chronic gastrointestinal (GI) symptoms not explained by identifiable organic pathology; accordingly, their diagnosis rests on symptom-based criteria and a process of exclusion. Evidence is lacking on the appropriate use of abdominal imaging studies (AIS) in FGIDs. METHODS: We investigated the utilisation of AIS (site, modality, diagnostic yield/significance) at a tertiary FGID clinic over an 11-year period. RESULTS: Of 1,621 patients, 507 (31 %; 67.5 % women, mean age 43.9 +/- 17.37 years) referred from primary care had 997 AIS (1.7 per patient): ultrasonography (US) 36.1 %, fluoroscopy (FLS) 28.8 %, computed tomography (CT) 19.6 %, plain radiography (PR) 13.5 %, nuclear medicine (NM) 1 %). Of the 997 AIS, 55.6 % (554/997) were normal. Of the AIS with positive findings, 9.9 % (62/625) were deemed 'probably significant' and 14.7 % (92/625) 'significant'. Of the CT and FLS studies, 12.3 % and 13.6 %, respectively, yielded 'significant' abnormalities compared to 2.2 % of the US studies and 2.1 % of the PR studies. CT identified five of seven neoplasms, associated with male sex, increasing age and symptom onset after age 50 years. CONCLUSIONS: This study confirmed low use of AIS in tertiary FGID clinics and a high proportion of normal studies. Barium swallow/meal and CT were more likely to identify 'probably significant' or 'significant' findings, including neoplasms. KEY POINTS: * Imaging referral rates from a specialist functional gastrointestinal disorder clinic are low * Despite this, normal studies are still frequent in those who are imaged * Ultrasonography was the most frequent investigation, yet yielded significant findings infrequently * Abdominal radiographs accounted for 13.5 % of investigations yet were normal in 71.8 % * CT and fluoroscopy were more likely to yield positive findings.
  - 0938-79940938-7994
DA  - 2014/12
ER  - 

@article{V280546404,
   = {Breen,  M. and Murphy,  K. P. and O'Neill,  S. B. and O'Donovan,  J. P. and McWilliams,  S. and Desmond,  A. N. and Shanahan,  F. and Quigley,  E. M. and Maher,  M. M. },
   = {2014},
   = {December},
   = {Eur Radioleur Radiol},
   = {The utilisation and diagnostic yield of radiological imaging in a specialist functional GI disorder clinic: an 11-year retrospective study},
   = {Validated},
   = {()},
   = {24},
   = {12},
  pages = {3097--3104},
   = {{OBJECTIVES: The term functional gastrointestinal disorders (FGID) describes various aggregations of chronic gastrointestinal (GI) symptoms not explained by identifiable organic pathology; accordingly, their diagnosis rests on symptom-based criteria and a process of exclusion. Evidence is lacking on the appropriate use of abdominal imaging studies (AIS) in FGIDs. METHODS: We investigated the utilisation of AIS (site, modality, diagnostic yield/significance) at a tertiary FGID clinic over an 11-year period. RESULTS: Of 1,621 patients, 507 (31 %; 67.5 % women, mean age 43.9 +/- 17.37 years) referred from primary care had 997 AIS (1.7 per patient): ultrasonography (US) 36.1 %, fluoroscopy (FLS) 28.8 %, computed tomography (CT) 19.6 %, plain radiography (PR) 13.5 %, nuclear medicine (NM) 1 %). Of the 997 AIS, 55.6 % (554/997) were normal. Of the AIS with positive findings, 9.9 % (62/625) were deemed 'probably significant' and 14.7 % (92/625) 'significant'. Of the CT and FLS studies, 12.3 % and 13.6 %, respectively, yielded 'significant' abnormalities compared to 2.2 % of the US studies and 2.1 % of the PR studies. CT identified five of seven neoplasms, associated with male sex, increasing age and symptom onset after age 50 years. CONCLUSIONS: This study confirmed low use of AIS in tertiary FGID clinics and a high proportion of normal studies. Barium swallow/meal and CT were more likely to identify 'probably significant' or 'significant' findings, including neoplasms. KEY POINTS: * Imaging referral rates from a specialist functional gastrointestinal disorder clinic are low * Despite this, normal studies are still frequent in those who are imaged * Ultrasonography was the most frequent investigation, yet yielded significant findings infrequently * Abdominal radiographs accounted for 13.5 % of investigations yet were normal in 71.8 % * CT and fluoroscopy were more likely to yield positive findings.OBJECTIVES: The term functional gastrointestinal disorders (FGID) describes various aggregations of chronic gastrointestinal (GI) symptoms not explained by identifiable organic pathology; accordingly, their diagnosis rests on symptom-based criteria and a process of exclusion. Evidence is lacking on the appropriate use of abdominal imaging studies (AIS) in FGIDs. METHODS: We investigated the utilisation of AIS (site, modality, diagnostic yield/significance) at a tertiary FGID clinic over an 11-year period. RESULTS: Of 1,621 patients, 507 (31 %; 67.5 % women, mean age 43.9 +/- 17.37 years) referred from primary care had 997 AIS (1.7 per patient): ultrasonography (US) 36.1 %, fluoroscopy (FLS) 28.8 %, computed tomography (CT) 19.6 %, plain radiography (PR) 13.5 %, nuclear medicine (NM) 1 %). Of the 997 AIS, 55.6 % (554/997) were normal. Of the AIS with positive findings, 9.9 % (62/625) were deemed 'probably significant' and 14.7 % (92/625) 'significant'. Of the CT and FLS studies, 12.3 % and 13.6 %, respectively, yielded 'significant' abnormalities compared to 2.2 % of the US studies and 2.1 % of the PR studies. CT identified five of seven neoplasms, associated with male sex, increasing age and symptom onset after age 50 years. CONCLUSIONS: This study confirmed low use of AIS in tertiary FGID clinics and a high proportion of normal studies. Barium swallow/meal and CT were more likely to identify 'probably significant' or 'significant' findings, including neoplasms. KEY POINTS: * Imaging referral rates from a specialist functional gastrointestinal disorder clinic are low * Despite this, normal studies are still frequent in those who are imaged * Ultrasonography was the most frequent investigation, yet yielded significant findings infrequently * Abdominal radiographs accounted for 13.5 % of investigations yet were normal in 71.8 % * CT and fluoroscopy were more likely to yield positive findings.}},
  issn = {0938-79940938-7994},
  source = {IRIS}
}