Guidelines for the Endoscopic Diagnosis of Ulcerative Colitis Are Not Followed in a Substantial Proportion of Patients: Real‐World Use of Colonoscopy Versus Sigmoidoscopy—A Copenhagen Inflammatory Bowel Disease Inception Cohort Study
Abstract
Evaluating whether international endoscopic diagnostic guideline recommendations regarding ulcerative colitis are followed in routine clinical practice, and assessing the clinical value of performing a follow‐up ileocolonoscopy in patients diagnosed based on a sigmoidoscopy.
This observational cohort study included all newly diagnosed adult patients with ulcerative colitisdiagnosed between May 1, 2021, and April 30, 2023, from The Copenhagen Inflammatory Bowel Disease Inception Cohort. The study included both patients with the initial endoscopic procedure done at a hospital or a private practice and three guideline‐adherent work‐up criteria were defined.
In total, 300 patients fulfilled inclusion criteria. Initial ileocolonoscopy with biopsies was performed in 190 patients, and among 101 patients with an initial sigmoidoscopy (including eight presenting with acute severe ulcerative colitis), 34 patients had a follow‐up ileocolonoscopy performed within 15 months. In total, 147 patients (49%) fulfilled the guideline‐adherent work‐up criteria. No significant differences were found when comparing, CRP, and fecal calprotectin, among other parameters, between patients who did and did not have a follow‐up ileocolonoscopy performed after the initial sigmoidoscopy.
Half of the patients fulfilled the guideline‐adherent work‐up criteria. Nonadherence to the defined guideline criteria was mainly the absence of a follow‐up ileocolonoscopy within 15 months. Guideline adherence differed…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 300 participants or records.
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