Accurate and timely diagnosis of eosinophilic esophagitis improves over time in Europe: an analysis of the EoE CONNECT Registry
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- dc.contributor.author Navarro Medrano, Pilar
- dc.contributor.author Navés, Juan Enrique
- dc.contributor.author Lucendo, Alfredo J.
- dc.date.accessioned 2023-01-09T07:20:00Z
- dc.date.available 2023-01-09T07:20:00Z
- dc.date.issued 2022
- dc.description.abstract Background: poor adherence to clinical practice guidelines for eosinophilic esophagitis (EoE) has been described and the diagnostic delay of the disease continues to be unacceptable in many settings. Objective: to analyze the impact of improved knowledge provided by the successive international clinical practice guidelines on reducing diagnostic delay and improving the diagnostic process for European patients with EoE. Methods: cross-sectional analysis of the EoE CONNECT registry based on clinical practice. Time periods defined by the publication dates of four major sets of guidelines over 10 years were considered. Patients were grouped per time period according to date of symptom onset. Results: data from 1,132 patients was analyzed and median (IQR) diagnostic delay in the whole series was 2.1 (0.7-6.2) years. This gradually decreased over time with subsequent release of new guidelines (p < 0.001), from 12.7 years up to 2007 to 0.7 years after 2017. The proportion of patients with stricturing of mixed phenotypes at the point of EoE diagnosis also decreased over time (41.3% vs. 16%; p < 0.001), as did EREFS scores. The fibrotic sub-score decreased from a median (IQR) of 2 (1-2) to 0 (0-1) when patients whose symptoms started up to 2007 and after 2017 were compared (p < 0.001). In parallel, symptoms measured with the Dysphagia Symptoms Score reduced significantly when patients with symptoms starting before 2007 and after 2012 were compared. A reduction in the number of endoscopies patients underwent before the one that achieved an EoE diagnosis, and the use of allergy testing as part of the diagnostic workout of EoE, also reduced significantly over time (p = 0.010 and p < 0.001, respectively). Conclusion: the diagnostic work-up of EoE patients improved substantially over time at the European sites contributing to EoE CONNECT, with a dramatic reduction in diagnostic delay.
- dc.format.mimetype application/pdf
- dc.identifier.citation Navarro P, Laserna-Mendieta EJ, Casabona S, Savarino E, Pérez-Fernández MT, Ghisa M, et al. Accurate and timely diagnosis of eosinophilic esophagitis improves over time in Europe: an analysis of the EoE CONNECT Registry. United European Gastroenterol J. 2022 Jun; 10(5): 507-17. DOI: 10.1002/ueg2.12240
- dc.identifier.doi http://dx.doi.org/10.1002/ueg2.12240
- dc.identifier.issn 2050-6406
- dc.identifier.uri http://hdl.handle.net/10230/55234
- dc.language.iso eng
- dc.publisher SAGE Publications
- dc.rights Copyright © 2022, Navarro P, Laserna-Mendieta EJ, Casabona S, Savarino E, Pérez-Fernández MT, Ghisa M, et al. United European Gastroenterology Journal published by Wiley Periodicals LLC on behalf of United European Gastroenterology. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
- dc.rights.accessRights info:eu-repo/semantics/openAccess
- dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
- dc.subject.keyword Diagnostic delay
- dc.subject.keyword Endoscopy
- dc.subject.keyword Eosinophilic esophagitis
- dc.subject.keyword Gastrointestinal
- dc.subject.keyword Guideline Adherence
- dc.subject.keyword Practice Guidelines as Topic
- dc.subject.keyword Registries
- dc.title Accurate and timely diagnosis of eosinophilic esophagitis improves over time in Europe: an analysis of the EoE CONNECT Registry
- dc.type info:eu-repo/semantics/article
- dc.type.version info:eu-repo/semantics/publishedVersion