Evidence map›Paper›PMID 33555540›Full record

ArticleInternal and emergency medicine2021

Clinical care pathway program versus open-access system: a study on appropriateness, quality, and efficiency in the delivery of colonoscopy in the colorectal cancer.

Giovanna Del Vecchio Blanco, Rami Dwairi, Mario Giannelli, Giampiero Palmieri, Vincenzo Formica, Ilaria Portarena, Enrico Grasso, Laura Di Iorio, Michela Benassi, Emilia Anna Giudice and 6 more

Open access · hybridAbstract read
In one paragraph

Article in Internal and emergency medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.3field-weighted citation impact, top 43% 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

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. 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

16 authors at 2 institutions in 2 countries.

Giovanna Del Vecchio BlancoDepartment of Systems Medicine, Gastroenterology Unit, University of Rome "Tor Vergata", Rome, Italy. giovanna.del.vecchio.blanco@uniroma2.it.
Rami DwairiDepartment of Internal Medicine, University of Mutah, Karak, Jordan.
Mario GiannelliDepartment of Systems Medicine, Gastroenterology Unit, University of Rome "Tor Vergata", Rome, Italy.
Giampiero PalmieriDepartment of Biomedicine and Prevention, Anatomic Pathology Unit, University "Tor Vergata", Rome, Italy.
Vincenzo FormicaDepartment of Oncohematology, Oncology Unit, University Tor Vergata, Rome, Italy.
Ilaria PortarenaDepartment of Oncohematology, Oncology Unit, University Tor Vergata, Rome, Italy.
Enrico GrassoDepartment of Systems Medicine, Gastroenterology Unit, University of Rome "Tor Vergata", Rome, Italy.
Laura Di IorioDepartment of Systems Medicine, Gastroenterology Unit, University of Rome "Tor Vergata", Rome, Italy.
Michela BenassiDepartment of Diagnostic Imaging, Interventional Radiology and Radiotherapy, University "Tor Vergata", Rome, Italy.
Emilia Anna GiudiceDepartment of Diagnostic Imaging, Interventional Radiology and Radiotherapy, University "Tor Vergata", Rome, Italy.
Antonella NardecchiaDepartment of Diagnostic Imaging, Interventional Radiology and Radiotherapy, University "Tor Vergata", Rome, Italy.
Piero RossiDepartment of Surgery, University Tor Vergata, Rome, Italy.
Mario RoselliDepartment of Oncohematology, Oncology Unit, University Tor Vergata, Rome, Italy.
Giuseppe SicaDepartment of Surgery, University Tor Vergata, Rome, Italy.
Giovanni MonteleoneDepartment of Systems Medicine, Gastroenterology Unit, University of Rome "Tor Vergata", Rome, Italy.
Omero Alessandro PaoluziDepartment of Systems Medicine, Gastroenterology Unit, University of Rome "Tor Vergata", Rome, Italy.ORCID http://orcid.org/0000-0002-5393-5796
University of Rome Tor Vergata · ITMutah University · JO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Open-access colonoscopy (OAC), whereby the colonoscopy is performed without a prior office visit with a gastroenterologist, is affected by inappropriateness which leads to overprescription and reduced availability of the procedure in case of alarming symptoms. The clinical care pathway (CCP) is a healthcare management tool promoted by national health systems to organize work-up of various morbidities. Recently, we started a CCP dedicated to colorectal cancer (CRC), including a colonoscopy session for CRC diagnosis and prevention. We aimed to evaluate the appropriateness, the quality, and the efficiency in the delivery of colonoscopy with the open-access system and a CCP program in the CRC. Quality indicators for colonoscopy in subjects in the CCP were compared to referrals by general practitioners (OAC) or by non-gastroenterologist physicians (non-gastroenterologist physician colonoscopy, NGPC). Attendance rate to colonoscopy was greater in the CCP group and NGPC group than in the OAC group (99%, 99%, and 86%, respectively). Waiting time in the CCP group was shorter than in the OAC group (3.88 ± 2.27 vs. 32 ± 22.31 weeks, respectively). Appropriateness of colonoscopy prescription was better in the CCP group than in the OAC group (92 vs. 50%, respectively). OAC is affected by the lack of timeliness and low appropriateness of prescription. A CCP reduces the number of inappropriate colonoscopies, especially for post-polypectomy surveillance, and improves the delivery of colonoscopy in patients requiring a fast-track examination. The high rate of inappropriate OAC suggests that this modality of healthcare should be widely reviewed.

Indexed as

Access to InformationQuality ImprovementAgedColonoscopyColorectal NeoplasmsFemaleHumansMaleMiddle AgedReferral and ConsultationClinical care pathwayColonoscopyColorectal cancerOpen-access colonoscopy

Identifiers

PMID33555540
PMCPMC8310505
OpenAlexW3128866172

What OpenQuestion holds

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Registered trials

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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.