Evidence map›Paper›PMID 30426298›Full record

ArticleDigestive diseases and sciences2019

Survey Study on the Practice Patterns of the Evaluation and Management of Incidental Pancreatic Cysts.

Donevan Westerveld, April Goddard, Nieka Harris, Vikas Khullar, Justin Forde, Peter V Draganov, Chris E Forsmark, Dennis Yang

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In one paragraph

Article in Digestive diseases and sciences, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.3field-weighted citation impact, top 37% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 7 citations in OpenAlex.

  1. Review
  2. Article
  3. Article
  4. Pancreatic cystic neoplasms: Adherence to management recommendations and associated endosonographic cyst characteristics.Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Donevan WesterveldDepartment of Internal Medicine, University of Florida, Gainesville, FL, USA.
April GoddardDivision of Gastroenterology and Hepatology, College of Medicine, University of Florida, 1329 SW 16th Street, Suite 5251, Gainesville, FL, 32608, USA.
Nieka HarrisDivision of Gastroenterology and Hepatology, College of Medicine, University of Florida, 1329 SW 16th Street, Suite 5251, Gainesville, FL, 32608, USA.
Vikas KhullarDivision of Gastroenterology and Hepatology, College of Medicine, University of Florida, 1329 SW 16th Street, Suite 5251, Gainesville, FL, 32608, USA.
Justin FordeDepartment of Internal Medicine, University of Florida, Gainesville, FL, USA.
Peter V DraganovDivision of Gastroenterology and Hepatology, College of Medicine, University of Florida, 1329 SW 16th Street, Suite 5251, Gainesville, FL, 32608, USA.
Chris E ForsmarkDivision of Gastroenterology and Hepatology, College of Medicine, University of Florida, 1329 SW 16th Street, Suite 5251, Gainesville, FL, 32608, USA.
Dennis YangDivision of Gastroenterology and Hepatology, College of Medicine, University of Florida, 1329 SW 16th Street, Suite 5251, Gainesville, FL, 32608, USA. Dennis.Yang@medicine.ufl.edu.ORCID 0000-0003-3038-4669
University of Florida · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsVarious gastrointestinal societies have released guidelines on the evaluation of asymptomatic pancreatic cysts (PCs). These guidelines differ on several aspects, which create a conundrum for clinicians. The aim of this study was to evaluate preferences and practice patterns in the management of incidental PCs in light of these societal recommendations.

methodsAn electronic survey distributed to members of the American Society for Gastrointestinal Endoscopy (ASGE). Main outcomes included practice setting (academic vs. community), preferences for evaluation, management, and surveillance strategies for PCs.

resultsA total of 172 subjects completed the study (52% academic-based endoscopists). Eighty-six (50%) and 138 (80%) of the participants responded that they would recommend EUS surveillance of incidental PCs measuring less than 2 cm and 3 cm, respectively. Nearly half of the endosonographers (42.5% community and 44% academic; p = 1.0) would routinely perform FNA on PCs without any high-risk features. More academic-based endoscopists (57% academic vs. 32% community; p = 0.001) would continue incidental PC surveillance indefinitely.

conclusionsThere is significant variability in the approach of incidental PCs among clinicians, with practice patterns often diverging from the various GI societal guideline recommendations. Most survey respondents would routinely recommend EUS-FNA and indefinite surveillance for incidental PCs without high-risk features. The indiscriminate use of EUS-FNA and indefinite surveillance of all incidental PCs is not cost-effective, exposes the patient to unnecessary testing, and can further perpetuate diagnostic uncertainty. Well-designed studies are needed to improve our diagnostic and risk stratification accuracy in order to formulate a consensus on the management of these incidental PCs.

Indexed as

GastroenterologistsGastroenterologyIncidental FindingsPractice Patterns, Physicians'Watchful WaitingAsymptomatic DiseasesClinical Decision-MakingEndoscopic Ultrasound-Guided Fine Needle AspirationEndoscopy, GastrointestinalGuideline AdherenceHealth Care SurveysHumansMagnetic Resonance ImagingPancreatic CystPractice Guidelines as TopicPredictive Value of TestsAdherence to guidelinesIncidental pancreatic cystsMRI surveillancePancreatic cystic neoplasms

Identifiers

PMID30426298
OpenAlexW2900675806

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.