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Lack of compliance with consensus recommendations on the diagnosis of eosinophilic esophagitis (EoE) in published prevalence studies. A clinical and systematic review
Author(s) -
GarcíaCompeán Diego,
GonzálezMoreno Emmanuel Irineo,
GonzálezGonzález José Alberto,
BorjasAlmaguer Omar David,
MaldonadoGarza Héctor Jesus
Publication year - 2016
Publication title -
journal of digestive diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 51
eISSN - 1751-2980
pISSN - 1751-2972
DOI - 10.1111/1751-2980.12400
Subject(s) - eosinophilic esophagitis , medicine , proton pump inhibitor , context (archaeology) , systematic review , protocol (science) , population , medline , intensive care medicine , pathology , disease , alternative medicine , paleontology , environmental health , political science , law , biology
Objective According to consensus recommendations, the presence of esophageal symptoms, >15 eosinophils/high‐power field and unresponsiveness to proton pump inhibitors are required for a diagnosis of eosinophilic esophagitis (EoE). Nevertheless, inconsistency in using these guidelines has been reported in recent publications. The objective of this study was to assess compliance with EoE diagnostic guidelines in published studies on EoE prevalence and to evaluate other clinical and methodological parameters. Methods A systematic review was conducted in articles published between 2008 and 2015 on the prevalence of EoE in unselected adults. Studies using EoE diagnostic definitions were judged to be compliant if they included all three components of the definition, partially compliant if they included two and non‐compliant if they included one or none. Esophageal biopsy protocol differences and descriptions of patients’ characteristics were determined. Results Among the 20 studies included, eight were performed in a hospital setting and 12 in the general population. Only 40.0% of studies were compliant, 35.0% were partially compliant and 25.0% were non‐compliant with the EoE diagnostic definition guidelines. In 60.0% of the studies a proton pump inhibitor trial was not administered. Only 30.0% adhered to the recommendations in the esophageal biopsy protocol. A lack of description of the history of atopia and endoscopic characteristics was observed in many studies. Conclusions Partial or non‐compliance with the EoE diagnostic definition was observed in most of the published prevalence studies after the publication of the first consensus. The results of these studies might be interpreted taking into account this context.