3413 The inappropriate use of colonoscopy in an openaccess setting: a prospective multicenter study

Background: Based on ASGE guidelines or complex derived criteria, mainly related to specific clinically scenarios, up to 30% of lower GI tract endoscopy (LE) are inappropriate in an open-access system. Aims: To assess a)the inappropriate rate of LE required by general practitioners (GPs) or specialists, and b)the clinical indications and diagnostic yield of inappropriate vs appropriate LE. Methods: From June to December 1998, consecutive patients referred for LE were prospectively studied. Before endoscopy, a questionnaire was filled to assess the appropriateness of the request in the 8 scheduled clinical situations in which ASGE-guidelines were reduced: screening, follow-up, long-lasting (>3 months) or recentonset symptoms or signs in patients never or already studied, operative endoscopy and to complete a previous colonic study (endoscopy or barium enema). Results: Out of 1045 LE, 154/393(40%) sent by GPs and 150/652 (23%)sent by specialists were judged inappropriate (p