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Related Experiment Videos

Sigmoidoscopy/proctoscopy service with open access to general practitioners.

I P Donald, J S FitzGerald Frazer, S P Wilkinson

    British Medical Journal (Clinical Research Ed.)
    |March 9, 1985
    PubMed
    Summary

    An open access sigmoidoscopy service significantly improved diagnostic rates for gastrointestinal conditions in primary care. This approach reduced barium enema requests, proving highly beneficial for general practitioners and patient care.

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    Area of Science:

    • Gastroenterology
    • Diagnostic Imaging
    • Primary Care Medicine

    Background:

    • Hospitals increasingly offer open access barium enema examinations, often bypassing initial sigmoidoscopy.
    • This practice led to a shift in diagnostic pathways, necessitating a re-evaluation of direct access procedures.

    Purpose of the Study:

    • To evaluate the effectiveness of an open access sigmoidoscopy/proctoscopy service for general practitioner referrals.
    • To assess the diagnostic yield and impact on barium enema utilization.

    Main Methods:

    • A prospective study of 1458 patients referred by general practitioners over 3.5 years.
    • Utilized rigid sigmoidoscopy, proctoscopy, and, when indicated, fiberoptic sigmoidoscopy for bleeding investigations.
    • Patient symptoms and diagnosed abnormalities were recorded.

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    Main Results:

    • A diagnostic rate of 35% was achieved, identifying 516 abnormalities in 506 patients.
    • The most common findings included hemorrhoids (307), inflammatory bowel disease (107), benign tumors (44), and malignant tumors (38).
    • Fiberoptic sigmoidoscopy identified causes for bleeding in 32 of 41 patients, including 16 malignant tumors.

    Conclusions:

    • Open access sigmoidoscopy/proctoscopy is a highly effective diagnostic tool in primary care settings.
    • The service demonstrated a substantial reduction in barium enema requests and was well-received by general practitioners.