Camilleri Michael, Katzka David A
Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota.
Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota.
Clin Gastroenterol Hepatol. 2016 Oct;14(10):1376-84. doi: 10.1016/j.cgh.2016.05.022. Epub 2016 May 20.
BACKGROUNG & AIMS: The objective of this review is to identify common areas in gastroenterology practice where studies performed provide an opportunity for enhancing value or lowering costs.
We provide examples of topics in gastroenterology where clinicians could enhance value by either using less invasive testing, choosing a single best test, or by using patient symptoms to guide additional testing.
The topics selected for review are selected in esophageal, pancreatic, and colorectal cancer; functional gastrointestinal diseases (irritable bowel syndrome, bacterial overgrowth, constipation); immune-mediated gastrointestinal diseases; and pancreaticobiliary pathology. We propose guidance to alter practice based on current evidence.
These studies support the need to review current practice and to continue performing research to further validate the proposed guidance to enhance value of care in gastroenterology and hepatology.
本综述的目的是确定胃肠病学实践中的常见领域，在这些领域所开展的研究为提高价值或降低成本提供了机会。
我们列举了胃肠病学中的一些主题实例，临床医生可通过采用侵入性较小的检查、选择最佳单一检查或利用患者症状来指导进一步检查，从而提高价值。
所选择进行综述的主题包括食管癌、胰腺癌和结直肠癌；功能性胃肠疾病（肠易激综合征、细菌过度生长、便秘）；免疫介导的胃肠疾病；以及胰腺胆道病理学。我们根据当前证据提出改变实践的指导建议。
这些研究支持有必要审视当前实践，并继续开展研究以进一步验证所提出的指导建议，从而提高胃肠病学和肝病学护理的价值。
