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What Is Appropriate Upper Endoscopic Interval Among Dyspeptic Patients With Previously Norma Endoscopy? A Multicenter Study With Bayesian Change Point Analysis

Title
What Is Appropriate Upper Endoscopic Interval Among Dyspeptic Patients With Previously Norma Endoscopy? A Multicenter Study With Bayesian Change Point Analysis
Authors
Kim, Jong WookJung, Kee WookKwon, Joong GooLee, Jung BokPark, Jong KyuBang, Ki BaeTae, Chung HyunOh, Jung Hwan
Ewha Authors
태정현
Issue Date
2019
Journal Title
JOURNAL OF NEUROGASTROENTEROLOGY AND MOTILITY
ISSN
2093-0879JCR Link

2093-0887JCR Link
Citation
JOURNAL OF NEUROGASTROENTEROLOGY AND MOTILITY vol. 25, no. 4, pp. 544 - 550
Keywords
Bayes theoremDyspepsiaGastroscopyIntervalStomach neoplasms
Publisher
KOREAN SOC NEUROGASTROENTEROLOGY &

MOTILITY
Indexed
SCIE; SCOPUS; KCI WOS
Document Type
Article
Abstract
Background/Aims Appropriate interval for performing follow-up endoscopy among dyspeptic patients without abnormal findings on previous endoscopy is unclear. We analyzed the multicenter-collected data from the Korean Society of Neurogastroenterology and Motility. Methods We collected clinical data of the patients who visited the gastroenterology department and underwent 2 or more sessions of upper endoscopy during 2012-2017 at 6 university hospitals in Korea. Patients with endoscopic interval between 90 days and 760 days were included. For those with multiple endoscopic sessions, only the first 2 were analyzed. Positive outcome was defined as adenoma or cancer in the upper gastrointestinal tract. To identify the point of change and estimate the properties of the stochastic process before and after the change, we used Bayesian regression with Metropolis-Hastings algorithm. Results There were 1595 patients. Mean age was 58.8 years (standard deviation, 12.8). Median interval of endoscopy was 437 days (standard deviation, 153). On follow-up endoscopy, there were 12 patients (0.75%) who had neoplasia (4 with gastric cancer and 8 with gastric adnoma). As with the prior hypothesis, we presumed the change point (CP) of increase in frequency of organic lesion as 360 days. After random-walk Metropolis-Hastings sampling with Markov-Chain Monte Carlo iterations of 5000, the CP was 560 days (95% credible interval, 139-724). Estimated average of frequency of dysplastic lesions increased by a factor of 4.4 after the estimated CP. Conclusion To rule out dysplastic lesions among dyspeptic patients who had previously normal endoscopy, a 2-year interval could be offered as follow-up interval for repeat upper endoscopy.
DOI
10.5056/jnm19063
Appears in Collections:
의과대학 > 의학과 > Journal papers
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