Navigation Links
New research identifies practice changes to improve value and quality of GI procedures

Orlando, FL (May 18, 2013) There are significant cost and risk factors associated with two procedures commonly used to diagnose or treat gastrointestinal problems, according to research presented at Digestive Disease Week (DDW).

A study by New York Presbyterian Hospital and Weill-Cornell Medical College suggests that more objective testing may substantially reduce the cost and risk of managing gastroesophageal reflux disease (GERD). Although GERD is believed to affect nearly 25 percent of adults, researchers found that almost a third of patients undergoing treatment have no measurable signs of the chronic condition. The study projected cost-savings of up to $7,300 per patient over 10 years if current diagnostic guidelines were changed.

"Many patients remain on proton-pump inhibitors for years after the trial period without any confirmation that they are being treated for the right diagnosis," said David Kleiman, MD, a research fellow in the department of surgery at New York Presbyterian Hospital. "A prompt pH monitoring test could help clinicians to accurately diagnosis GERD, increase healthy outcomes for patients and save people money."

GERD occurs when stomach acid or bile flows back into the food pipe from the stomach, causing acid reflux and heartburn. Methods for diagnosing and treating it remain controversial. Most guidelines recommend an eight-week trial of proton-pump inhibitors (PPI) to reduce acid secretion. Clinicians then observe the patient to see if symptoms subside.

The study compared this approach with 24-hour esophageal pH monitoring, in which a small tube is passed through the nose into the stomach. The tube is attached to a recorder worn at the belt to track acid levels.

"The misconceptions about pH monitoring are that it's unnecessary, expensive or too inconvenient," added Dr. Kleiman. "But, the benefits seen in our study show that pH monitoring should be strongly considered."

Using patient data from the esophageal monitoring, Dr. Kleiman and colleagues found that 32 percent of individuals who were taking PPIs had no objective signs of GERD pointing to unnecessary spending on medication and increased risk from prolonged PPI use.

Dr. Kleiman concluded that patients should be considered for pH monitoring immediately after their eight-week PPI trial.

Data points to strategies to avoid GI surgery readmissions

Other cost-saving data presented at DDW zeros in on the risk factors associated with surgical readmission in major gastrointestinal resections. Unplanned readmissions are estimated to cost $17 billion annually in the U.S., but many are preventable. Researchers at the University of Rochester Medical Center analyzed data from nearly 45,000 patients undergoing GI surgery and found that if patients have a complication in the hospital, they are one third more likely to be readmitted. This is one of the largest studies to date to focus on readmissions following gastrointestinal surgery.

"This finding tells us that we need to take a closer look at discharge plans after complications occur," said Fergal Fleming, assistant professor of surgery and oncology and clinical director of Surgical Health Outcomes and Research Enterprise (SHORE) at the University of Rochester Medical Center.

Data from Dr. Fleming's study found the unplanned readmission rate for patients undergoing gastrointestinal resection was 12 percent. The estimated cost for a readmission ranges from $5,000 to $15,000. His analysis also identified preoperative steroid use, operative time and discharge to a facility other than home as risk factors.

"These data provide us with a roadmap for cost-saving, preventative measures that we can study to improve care and increase healthy outcomes," he said.


Contact: Aimee Frank
Digestive Disease Week

Related medicine news :

1. UCLA Brain Injury Research Center gets NCAA funding for research on sports concussions
2. NIH awards $20 million over 5 years to train next generation of global health researchers
3. Researchers develop a new cell and animal model of inflammatory breast cancer
4. Researchers uncover a viable way for colorectal cancer patients to overcome drug resistance
5. Sexually abused boys at risk for more unsafe sex: UBC research
6. Researchers Find Gene Mutations That May Be a Key to Autism
7. LSUHSC research finds HPV-related head & neck cancers rising, highest in middle-aged white men
8. Researchers find evidence of banned antibiotics in poultry products
9. Presidential keynote address and new research highlights from the American Society of Pediatric Otolaryngology meeting
10. Scientific session and new research highlights
11. NJ stroke researchers report advances in spatial neglect research at AAN Conference
Post Your Comments:
(Date:11/27/2015)... ... 2015 , ... MPWH, the No.1 Herpes-only dating community in the world, revealed that over 50% ... More than 3.7 billion people under the age of 50 – or 67% of the ... first global estimates of HSV-1 infection . , "The data shocks us highly!" said ...
(Date:11/27/2015)... ... November 27, 2015 , ... A simply groundbreaking television series, "Voices in ... that delves into an array of issues that are presently affecting Americans. Dedicated to ... dialogue, this show is changing the subjects consumers focus on, one episode at a ...
(Date:11/27/2015)... Angeles, CA (PRWEB) , ... November 27, 2015 , ... ... Commission on Accreditation of Allied Health Education Programs (CAAHEP) awarded accreditation to its Diagnostic ... list of CAAHEP accredited colleges, as only one of twelve colleges and universities in ...
(Date:11/27/2015)... San Francisco, California (PRWEB) , ... November 27, 2015 , ... ... 1969 Janis Joplin Ann Arbor Michigan boxing style concert posters. This is one of ... 1969 at the Canterbury House at the University of Michigan in Ann Arbor. The ...
(Date:11/26/2015)... , ... November 26, 2015 , ... Inevitably when people ... customers choose to buy during the Black Friday and Cyber Monday massage ... need to search the Internet high and low to find the best massage chair ...
Breaking Medicine News(10 mins):
(Date:11/26/2015)... Países Bajos, November 26, 2015 ... fotodinámica de Bremachlorin para el cáncer avanzado.   ... con la terapia fotodinámica de Bremachlorin para el cáncer ... enfoque combina la inmunoterapia con la terapia fotodinámica de ... Clinical Cancer Research . --> Clinical Cancer ...
(Date:11/26/2015)... Netherlands , November 26, 2015 ... A new combination approach blends immunotherapy with Bremachlorin-photodynamic ... A new combination approach blends immunotherapy with Bremachlorin-photodynamic therapy ... A new combination approach blends immunotherapy with Bremachlorin-photodynamic therapy ... Netherlands has found that immunotherapy can be ...
(Date:11/26/2015)... November 26, 2015 --> ... use SyMRI to find optimal contrast weighting of MRI ... and has signed a research agreement with SyntheticMR in order ... Using SyMRI, it is possible to generate multiple contrast images ... the patient has left, thus making it possible to both ...
Breaking Medicine Technology: