Appropriateness of upper gastrointestinal endoscopy referrals from primary health care

open-access endoscopy is defined as “the provision of a diag-nostic endoscopic procedure by direct request of a general practitioner without prior hospital consultation”.1 Althoughopen access is needed to meet the increasing demand for endoscopy service, studies suggest there is a link between such a system and inap-propriate use of esophagogastroduodenoscopy (eGD), particularly in primary care.2-8 to ensure the appropriateness of eGD, the American Society for Gastrointestinal endoscopy (ASGe) has developed criteria to promote safe and responsible endoscopic practice.9 in Saudi Arabia,gastrointestinal symptoms are common, with normal endoscopic find-ings ranging from 23.5% to 29%,10-14 but there is little, if any, appli-cation of standard criteria to judge the use of endoscopy. This study examined the appropriateness of eGD referrals from primary health care (pHC) and the association between appropriate use and the pres-ence of significant lesions detected by endoscopy using standard criteria developed by the ASGe.