OBJECTIVE: To evaluate the 'natural history' of outpatients who were referred to the Division of Gastroenterology at the University of Alberta Hospital (Edmonton, Alberta) for gastrointestinal problems and were subsequently declined. METHODS: Patients were tracked for 12 months after they were referred and declined for the following indications: abdominal pain, rectal bleeding, fecal occult blood test-positive stools and iron deficiency. For each patient, data regarding consultations by other gastroenterologists or surgeons working in the region, clinically relevant diagnoses and the number of gastrointestinal-related x-rays performed were obtained. RESULTS: Of a total sample size of 230 patients, 110 (47.8%) were seen by another gastroenterologist or surgeon after decline. A significant diagnosis was made in 21 patients (9.1%), which had immediate clinical consequences in 29%. Forty per cent of patients underwent one or more gastointestinal-related x-rays before being declined, which increased to 55% after decline. CONCLUSION: Approximately 50% of declined patients were seen by other gastroenterologists or surgeons in the region. In 9.1% of these patients, a clinically important diagnosis was made, of which one-quarter had immediate medical consequences.
OBJECTIVE: To evaluate the 'natural history' of outpatients who were referred to the Division of Gastroenterology at the University of Alberta Hospital (Edmonton, Alberta) for gastrointestinal problems and were subsequently declined. METHODS:Patients were tracked for 12 months after they were referred and declined for the following indications: abdominal pain, rectal bleeding, fecal occult blood test-positive stools and iron deficiency. For each patient, data regarding consultations by other gastroenterologists or surgeons working in the region, clinically relevant diagnoses and the number of gastrointestinal-related x-rays performed were obtained. RESULTS: Of a total sample size of 230 patients, 110 (47.8%) were seen by another gastroenterologist or surgeon after decline. A significant diagnosis was made in 21 patients (9.1%), which had immediate clinical consequences in 29%. Forty per cent of patients underwent one or more gastointestinal-related x-rays before being declined, which increased to 55% after decline. CONCLUSION: Approximately 50% of declined patients were seen by other gastroenterologists or surgeons in the region. In 9.1% of these patients, a clinically important diagnosis was made, of which one-quarter had immediate medical consequences.
Authors: Desmond Leddin; Ronald J Bridges; David G Morgan; Carlo Fallone; Craig Render; Victor Plourde; Jim Gray; Connie Switzer; Jim McHattie; Harminder Singh; Eric Walli; Iain Murray; Anthony Nestel; Paul Sinclair; Ying Chen; E Jan Irvine Journal: Can J Gastroenterol Date: 2010-01 Impact factor: 3.522
Authors: William G Paterson; William T Depew; Pierre Paré; Denis Petrunia; Connie Switzer; Sander J Veldhuyzen van Zanten; Sandra Daniels Journal: Can J Gastroenterol Date: 2006-06 Impact factor: 3.522
Authors: W G Paterson; A N Barkun; W M Hopman; D J Leddin; P Paré; D M Petrunia; M J Sewitch; C Switzer; S Veldhuyzen van Zanten Journal: Can J Gastroenterol Date: 2010-01 Impact factor: 3.522
Authors: V de Jonge; J Sint Nicolaas; M E van Leerdam; E J Kuipers; S J O Veldhuyzen van Zanten Journal: Endoscopy Date: 2011-03-24 Impact factor: 10.093
Authors: D Armstrong; A Ng Barkun; Y Chen; S Daniels; R Hollingworth; R H Hunt; D Leddin Journal: Can J Gastroenterol Date: 2008-02 Impact factor: 3.522
Authors: D Leddin; D Armstrong; A Ng Barkun; Y Chen; S Daniels; R Hollingworth; R H Hunt; W G Paterson Journal: Can J Gastroenterol Date: 2008-02 Impact factor: 3.522