Ann Intern Med. 2014 Feb 4;160(3):154. doi: 10.7326/M13-0046.
Esophagogastroduodenoscopy (EGD) is done often for various indications. Little is known about the frequency of repeated EGD and the diagnoses that drive it.
To describe the frequency of repeated EGD in the Medicare population and determine diagnoses most often associated with it.
Retrospective analysis.
Medicare database.
Among a 5% random sample of Medicare beneficiaries, Current Procedural Terminology (CPT) codes were used to identify patients who had an index EGD between 2004 and 2006. Diagnoses from the International Classification of Diseases, Ninth Revision, Clinical Modification, reported for the index endoscopy were divided into 3 diagnostic groups on the basis of whether the index diagnosis suggested that repeated EGD was expected, uncertain, or not expected.
Proportion of patients with repeated EGD within 3 years of an index EGD.
Approximately 12% of Medicare beneficiaries had an EGD between 2004 and 2006 (n = 108 785). Of these, 33% (n = 36 331) had at least 1 repeated EGD within 3 years. Of all patients with initial EGDs, 10% (n = 11 370) had an associated diagnosis suggesting a need for follow-up examination, whereas 61% (n = 66 307) did not. Of all patients with repeated examinations, 54% (n = 19 687) came from the group in which repeated EGD was not expected. When new clinical events were excluded, 43% of all patients with repeated EGDs (n = 15 706) did not have a diagnosis at index or repeated EGD that justified a repeated examination.
Whether individual procedures were clinically indicated cannot be verified.
One in 3 Medicare beneficiaries who received an EGD had a repeated EGD within 3 years. Nearly one half of repeated examinations were done in patients with diagnoses at index or repeated EGD that did not suggest the need for a repeated examination.
None.
食管胃十二指肠镜检查（EGD）常用于各种适应证。对于重复 EGD 的频率及其驱动因素知之甚少。
描述医疗保险人群中重复 EGD 的频率，并确定与之最相关的诊断。
回顾性分析。
医疗保险数据库。
在医疗保险受益人的 5%随机样本中，使用当前程序术语（CPT）代码来识别 2004 年至 2006 年之间进行索引 EGD 的患者。为索引内镜报告的国际疾病分类，第九修订版，临床修正，根据索引诊断是否提示预期、不确定或不预期需要重复 EGD，将诊断分为 3 个诊断组。
索引 EGD 后 3 年内重复 EGD 的患者比例。
大约 12%的医疗保险受益人在 2004 年至 2006 年期间进行了 EGD（n=108785）。其中，33%（n=36331）在 3 年内至少进行了 1 次重复 EGD。在所有进行初始 EGD 的患者中，10%（n=11370）的诊断提示需要随访检查，而 61%（n=66307）没有。在所有重复检查的患者中，54%（n=19687）来自重复 EGD 不被预期的组。当排除新的临床事件后，43%的所有重复 EGD 患者（n=15706）在索引或重复 EGD 时没有诊断出需要重复检查的诊断。
不能验证单个程序是否具有临床指征。
接受 EGD 的医疗保险受益人中，有 1/3 的人在 3 年内进行了重复 EGD。近一半的重复检查是在索引或重复 EGD 时没有诊断出需要重复检查的患者中进行的。
无。
