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Canadian Journal of Gastroenterology - Volume 26 2012, Issue 11, Pages 785-790

Original Article

Leiden University, Leiden, The Netherlands

University of Alberta Hospital, Edmonton, Alberta, Canada

Received 11 April 2012; Accepted 12 April 2012

Copyright © 2012 Hindawi Publishing Corporation. This open-access article is distributed under the terms of the Creative Commons Attribution Non-Commercial License CC BY-NC, which permits reuse, distribution and reproduction of the article, provided that the original work is properly cited and the reuse is restricted to noncommercial purposes.


OBJECTIVE: To evaluate the ‘natural history’ of outpatients who were referred to the Division of Gastroenterology at the University of Alberta Hospital Edmonton, Alberta for gastrointestinal problems and were subsequently declined.

METHODS: Patients were tracked for 12 months after they were referred and declined for the following indications: abdominal pain, rectal bleeding, fecal occult blood test-positive stools and iron deficiency. For each patient, data regarding consultations by other gastroenterologists or surgeons working in the region, clinically relevant diagnoses and the number of gastrointestinal-related x-rays performed were obtained.

RESULTS: Of a total sample size of 230 patients, 110 47.8% were seen by another gastroenterologist or surgeon after decline. A significant diagnosis was made in 21 patients 9.1%, which had immediate clinical consequences in 29%. Forty per cent of patients underwent one or more gastointestinal-related x-rays before being declined, which increased to 55% after decline.

CONCLUSION: Approximately 50% of declined patients were seen by other gastroenterologists or surgeons in the region. In 9.1% of these patients, a clinically important diagnosis was made, of which one-quarter had immediate medical consequences.

Autor: Emelie M de Boer, David Pincock, and Sander Veldhuyzen van Zanten



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