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Related Experiment Videos

The barium enema; evidence for proper utilization.

D E Gerson, A M Lewicki, B J McNeil

    Radiology
    |February 1, 1979
    PubMed
    Summary

    Selecting patients for barium enemas based solely on specific disease indicators could miss 10% of gastrointestinal disease cases. This highlights the need for careful consideration of clinical symptoms alongside diagnostic indicators for accurate large bowel disease detection.

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    Area of Science:

    • Gastroenterology
    • Diagnostic Imaging

    Background:

    • Barium enemas are a common diagnostic tool for large bowel disease.
    • Identifying optimal patient selection criteria can improve diagnostic yield and resource allocation.

    Purpose of the Study:

    • To identify symptoms, signs, or laboratory findings associated with high or low yield of abnormal barium enemas.
    • To evaluate the impact of selecting patients based on statistically significant or clinically important indicators.

    Main Methods:

    • Retrospective analysis of 1,041 patient cases undergoing barium enema.
    • Statistical analysis to identify significant indicators of large bowel disease.

    Main Results:

    • Eliminating examinations based solely on statistically significant indicators (fever, positive stool benzidine, mass, low hematocrit) or clinical indicators (weight loss, altered bowel habits) would reduce examinations by 13%.

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  • However, this selective approach would result in missing 10% of patients with actual gastrointestinal disease.

    • Conclusions:

    • Strict adherence to statistically significant or clinically important indicators for barium enema may lead to underdiagnosis.
    • A balance between diagnostic indicators and clinical judgment is crucial for effective large bowel disease screening.