Survey of Access to GastroEnterology in Canada: The SAGE Wait Times Program

Mb, Desmond Leddin; Bridges, Ronald; Morgan, David; Fallone, Carlo A; Render, Craig; Plourde, Victor; Gray, James U.; Switzer, Connie; McHattie, Jim; Singh, Harminder; Walli, Eric; Murray, Iain A.; Nestel, Anthony; Sinclair, Paul; Chen, Ying; Irvine, E. Jan

doi:10.1155/2010/246492

Cited by 30 publications

(35 citation statements)

References 7 publications

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“…Even without a (colonoscopy) screening program, several countries already have a waiting list for colonoscopy, with waiting times of more than 6 months reported (63–65). Implementing a guaiac FOBT screening pilot has been shown to increase colonoscopy activity by 21%–31% (66).…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of Colorectal Cancer Screening

Lansdorp–Vogelaar¹,

Knudsen²,

Brenner³

2011

Epidemiologic Reviews

260

175

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Colorectal cancer is an important public health problem. Several screening methods have been shown to be effective in reducing colorectal cancer mortality. The objective of this review was to assess the cost-effectiveness of the different colorectal cancer screening methods and to determine the preferred method from a cost-effectiveness point of view. Five databases (MEDLINE, EMBASE, the Cost-Effectiveness Analysis Registry, the British National Health Service Economic Evaluation Database, and the lists of technology assessments of the Centers for Medicare and Medicaid Services) were searched for cost-effectiveness analyses published in English between January 1993 and December 2009. Fifty-five publications relating to 32 unique cost-effectiveness models were identified. All studies found that colorectal cancer screening was cost-effective or even cost-saving compared with no screening. However, the studies disagreed as to which screening method was most effective or had the best incremental cost-effectiveness ratio for a given willingness to pay per life-year gained. There was agreement among studies that the newly developed screening tests of stool DNA testing, computed tomographic colonography, and capsule endoscopy were not yet cost-effective compared with the established screening options.

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Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of Colorectal Cancer Screening

Lansdorp–Vogelaar¹,

Knudsen²,

Brenner³

2011

Epidemiologic Reviews

260

175

View full text Add to dashboard Cite

show abstract

“…In 2008, the Survey of Access to Gastroenterology in Canada (SAGE) study analyzed whether these consensus targets were being met. This study identified two types of wait lists central to GI: one for specialist consultation and one for diagnostic procedures (5). It was concluded that both wait lists were longer than published consensus targets, and this was also demonstrated in other studies (5)(6)(7)(8).…”

mentioning

confidence: 53%

“…In the pediatric population, patients are not referred for endoscopy for screening purposes, but rather because they are symptomatic. Thus, it seems reasonable that wait times in pediatric GI should be shorter than adult wait times (5). The SAGE study compared its results with the consensus targets established in 2005 and concluded that these targets were not being met in adult GI.…”

Section: Discussionmentioning

confidence: 99%

General Anesthetic Versus Light Sedation: Effect on Pediatric Endoscopy Wait Times

Edwards

Kapoor

Samuel

et al. 2013

Canadian Journal of Gastroenterology

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“…Direct to colonoscopy, also referred to as “open access colonoscopy”, allows for provision of a colonoscopy without clinical consultation with the endoscopist prior to the day of the procedure. In an era of lengthy consultation waitlists and limited clinic resources[2], this pathway has potential to facilitate expedited clinical care for many patients. Timely access is critical because delays in diagnostic colonoscopy may result in significant delays in cancer diagnosis[3,4].…”

Section: Introductionmentioning

confidence: 99%

Information seeking and anxiety among colonoscopy-naïve adults: Direct-to-colonoscopy vs traditional consult-first pathways

Silvester

Kalkat

Graff

et al. 2016

WJGE

Self Cite

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AIMTo investigate the effects of direct to colonoscopy pathways on information seeking behaviors and anxiety among colonoscopy-naïve patients.METHODSColonoscopy-naïve patients at two tertiary care hospitals completed a survey immediately prior to their scheduled outpatient procedure and before receiving sedation. Survey items included clinical pathway (direct or consult), procedure indication (cancer screening or symptom investigation), telephone and written contact from the physician endoscopist office, information sources, and pre-procedure anxiety. Participants reported pre-procedure anxiety using a 10 point scale anchored by “very relaxed” (1) and “very nervous” (10). At least three months following the procedure, patient medical records were reviewed to determine sedative dose, procedure indications and any adverse events. The primary comparison was between the direct and consult pathways. Given the very different implications, a secondary analysis considering the patient-reported indication for the procedure (symptoms or screening). Effects of pathway (direct vs consult) were compared both within and between the screening and symptom subgroups.RESULTSOf 409 patients who completed the survey, 34% followed a direct pathway. Indications for colonoscopy were similar in each group. The majority of the participants were women (58%), married (61%), and internet users (81%). The most important information source was family physicians (Direct) and specialist physicians (Consult). Use of other information sources, including the internet (20% vs 18%) and Direct family and friends (64% vs 53%), was similar in the Direct and Consult groups, respectively. Only 31% of the 81% who were internet users accessed internet health information. Most sought fundamental information such as what a colonoscopy is or why it is done. Pre-procedure anxiety did not differ between care pathways. Those undergoing colonoscopy for symptoms reported greater anxiety [mean 5.3, 95%CI: 5.0-5.7 (10 point Likert scale)] than those for screening colonoscopy (4.3, 95%CI: 3.9-4.7).CONCLUSIONProcedure indication (cancer screening or symptom investigation) was more closely associated with information seeking behaviors and pre-procedure anxiety than care pathway.

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Survey of Access to GastroEnterology in Canada: The SAGE Wait Times Program

Abstract: Median wait times for gastroenterology services continue to exceed consensus conference recommended targets and have significantly worsened since 2005.

Cited by 30 publications

References 7 publications

Cost-effectiveness of Colorectal Cancer Screening

Cost-effectiveness of Colorectal Cancer Screening

General Anesthetic Versus Light Sedation: Effect on Pediatric Endoscopy Wait Times

Information seeking and anxiety among colonoscopy-naïve adults: Direct-to-colonoscopy vs traditional consult-first pathways

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