Patterns of endoscopy use in the United States

Background & Aims: The aim of this study was to use a large national endosc opic database to determine why routine endoscopy is performed in diverse pr actice settings. Methods: A computerized endoscopic report generator was de veloped and disseminated to gastrointestinal (GI) specialists in diverse pr actice settings. after reports were generated, a data file was transmitted electronically to a central databank, where data were merged from multiple sites for analysis. Results: From April 1, 1997, to October 28, 1998, 276 p hysicians in 31 practice sites in 21 states provided 18,444 esophagogastrod uodenoscopy (EGD) reports, 20,748 colonoscopy reports, and 9767 flexible si gmoidoscopy reports to the central databank, EGD was most commonly performe d to evaluate dyspepsia and/or abdominal pain (23.7%), dysphagia (20%), sym ptoms of gastroesophageal reflux without dysphagia (17%), and suspected upp er GI bleeding (16.3%). Colonoscopy was most often performed for surveillan ce of prior neoplasia(24%) and evaluation of hematochezia (19%) or positive fecal occult blood test (15%), Flexible sigmoidoscopy was most commonly pe rformed for routine screening (40%) and evaluation of hematochezia (22%). T here were significant differences between academic and nonacademic sites, C onclusions: The endoscopic database can be an important resource for future research in endoscopy by documenting current practice patterns and changes in practice over time.