Accurate and timely diagnosis of Eosinophilic Esophagitis improves over time in Europe. An analysis of the EoE CONNECT Registry
Navarro Sánchez, Pilar (Instituto de Investigación Sanitaria de Castilla-La Mancha)
Laserna-Mendieta, Emilio J (Hospital Universitario de la Princesa (Madrid))
Casabona, Sergio (Hospital Universitario de la Princesa (Madrid))
Savarino, Edoardo (Azienda Ospedaliera di Padova)
Pérez-Fernández, María Teresa (Hospital Universitario de la Princesa (Madrid))
Ghisa, Matteo (Azienda Ospedaliera di Padova)
Pérez-Martínez, Isabel (Instituto de Investigación Sanitaria del Principado de Asturias)
Guagnozzi, Danila (Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas)
Perelló, Antonia (Hospital de Viladecans)
Guardiola-Arévalo, Antonio (Hospital Universitario de Fuenlabrada ( Madrid))
Racca, Francesca (Humanitas Research Hospital (Itàlia))
Betoré, Elena (Hospital Universitario Miguel Servet (Saragossa))
Blas-Jhon, Leonardo (Hospital Universitario Fundación Jiménez Díaz)
Krarup, Anne Lund (Hjoerring and Aalborg University)
Martín-Domínguez, Verónica (Hospital Universitario de la Princesa (Madrid))
Maniero, Daria (Azienda Ospedaliera di Padova)
Suárez, Adolfo (Instituto de Investigación Sanitaria del Principado de Asturias)
Llerena-Castro, Ronald (Hospital Universitari Vall d'Hebron)
de la Peña-Negro, Luisa (Hospital de Viladecans)
Navacerrada, Alicia Granja (Hospital Universitario de Fuenlabrada ( Madrid))
Pellegatta, Gaia (Humanitas Research Hospital (Itàlia))
Alcedo, Javier (Hospital Universitario Miguel Servet (Saragossa))
de Hurtado Mendoza-Guena, Lonore (Hospital Universitario Fundación Jiménez Díaz)
Feo-Ortega, Sara (Hospital General de Tomelloso)
Barrio, Jesús (Hospital Universitario Río Hortega (Valladolid))
Gutiérrez-Junquera, Carolina (Hospital Universitario Puerta de Hierro Majadahonda (Madrid))
Fernández-Fernández, Sonia (Hospital Universitario Severo Ochoa)
De la Riva, Susana (Clínica Universidad de Navarra)
E Navés, Juan (Parc de Salut MAR de Barcelona)
Carrión, Silvia (Hospital de Mataró. Consorci Sanitari del Maresme)
Ciriza de los Ríos, Constanza (Universidad Complutense de Madrid)
García-Morales, Natalia (Hospital Álvaro Cunqueiro (Vigo))
Rodríguez-Oballe, Juan Armando (Hospital Universitari Arnau de Vilanova)
Dainese, Raffaela (Centre Hospitalier d'Antibes Juan-les-Pins)
Rodríguez-Sánchez, Alba (Hospital Universitario Santa Lucía)
Masiques-Mas, María Lluisa (Hospital General de Granollers)
Palomeque, María Teresa (Complejo Hospitalario Universitario de Albacete)
Santander, Cecilio (Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas)
Tamarit-Sebastián, Sonsoles (Instituto de Investigación Sanitaria de Castilla-La Mancha)
Arias, Ángel (Hospital General Mancha-Centro)
Lucendo, Alfredo J (Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas)

Date:	2022
Abstract:	Poor adherence to clinical practice guidelines for eosinophilic esophagitis (EoE) has been described and the diagnostic delay of the disease continues to be unacceptable in many settings. To analyze the impact of improved knowledge provided by the successive international clinical practice guidelines on reducing diagnostic delay and improving the diagnostic process for European patients with EoE. Cross-sectional analysis of the EoE CONNECT registry based on clinical practice. Time periods defined by the publication dates of four major sets of guidelines over 10 years were considered. Patients were grouped per time period according to date of symptom onset. Data from 1,132 patients was analyzed and median (IQR) diagnostic delay in the whole series was 2. 1 (0. 7-6. 2) years. This gradually decreased over time with subsequent release of new guidelines (p < 0. 001), from 12. 7 years up to 2007 to 0. 7 years after 2017. The proportion of patients with stricturing of mixed phenotypes at the point of EoE diagnosis also decreased over time (41. 3% vs. 16%; p < 0. 001), as did EREFS scores. The fibrotic sub-score decreased from a median (IQR) of 2 (1-2) to 0 (0-1) when patients whose symptoms started up to 2007 and after 2017 were compared (p < 0. 001). In parallel, symptoms measured with the Dysphagia Symptoms Score reduced significantly when patients with symptoms starting before 2007 and after 2012 were compared. A reduction in the number of endoscopies patients underwent before the one that achieved an EoE diagnosis, and the use of allergy testing as part of the diagnostic workout of EoE, also reduced significantly over time (p = 0. 010 and p < 0. 001, respectively). The diagnostic work-up of EoE patients improved substantially over time at the European sites contributing to EoE CONNECT, with a dramatic reduction in diagnostic delay.
Grants:	Instituto de Salud Carlos III JR19/00005 Instituto de Salud Carlos III CD19/00102
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Diagnostic delay ; Endoscopy ; Eosinophilic esophagitis ; Gastrointestinal ; Guideline Adherence ; Practice Guidelines as Topic ; Registries
Published in:	United European Gastroenterology journal, Vol. 10 (may 2022) , p. 507-517, ISSN 2050-6414

DOI: 10.1002/ueg2.12240
PMID: 35578565

11 p, 883.1 KB

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