Reasonability of gastro-oesophageal reflux study requests (contrast swallows and milk scans) for the detection of gastro-oesophageal reflux disease at Red Cross War Memorial Children's Hospital - a retrospective analysis

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dc.contributor.advisorGoddard, Een_ZA
dc.contributor.advisorBrink, Anitaen_ZA
dc.contributor.advisorBanderker, Een_ZA
dc.contributor.authorBau, Steffenen_ZA
dc.date.accessioned2016-01-21T12:58:48Z
dc.date.available2016-01-21T12:58:48Z
dc.date.issued2015en_ZA
dc.descriptionIncludes bibliographical referencesen_ZA
dc.description.abstractPoor weight gain, recurrent vomiting and fussiness, chronic cough and recurrent chest infections are among the wide variety of signs that are often attributed to gastro-oesophageal reflux disease (GORD). The difficulty lies in distinguishing between physiological gastro-oesophageal reflux (GOR) and GORD and none of the tests available can, alone, give conclusive evidence for the latter. Clinicians are often at a loss which investigation to request in order to assess for GOR and assist in a diagnosis of GORD. Our hypothesis was that GORD investigations at Red Cross War Memorial Children's Hospital (RCWMCH) are requested without considering the appropriate modality required and without clear indications for suspecting GORD. This was supported by practical experience and a short preliminary review of request forms. In South Africa no specific guidelines exist regarding the diagnosis of GORD and there is a poor understanding of available tests and their role in aiding the diagnosis. Thus many unnecessary tests are requested. To review how appropriate the requests for GORD investigations were we analysed all requests made to the departments of nuclear medicine and radiology at RCWMCH for the purpose of GORD investigation between January and April 2011. This analysis was based on a review of the folders and the data of tests performed on all included patients. The two examination modalities involved were gastro-oesophageal radionuclide scintigrams (commonly known as milk scans) and contrast swallows. The specific points assessed were reasonability of the request, appropriate timing of the investigation, use of the correct modality for the question investigated and lastly evaluation of prior treatment with antacids. We found that most of the studies performed were requested on appropriate grounds and that the timing of the majority of the investigations was reasonable.en_ZA
dc.identifier.apacitationBau, S. (2015). <i>Reasonability of gastro-oesophageal reflux study requests (contrast swallows and milk scans) for the detection of gastro-oesophageal reflux disease at Red Cross War Memorial Children's Hospital - a retrospective analysis</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Department of Paediatrics and Child Health. Retrieved from http://hdl.handle.net/11427/16488en_ZA
dc.identifier.chicagocitationBau, Steffen. <i>"Reasonability of gastro-oesophageal reflux study requests (contrast swallows and milk scans) for the detection of gastro-oesophageal reflux disease at Red Cross War Memorial Children's Hospital - a retrospective analysis."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Department of Paediatrics and Child Health, 2015. http://hdl.handle.net/11427/16488en_ZA
dc.identifier.citationBau, S. 2015. Reasonability of gastro-oesophageal reflux study requests (contrast swallows and milk scans) for the detection of gastro-oesophageal reflux disease at Red Cross War Memorial Children's Hospital - a retrospective analysis. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Bau, Steffen AB - Poor weight gain, recurrent vomiting and fussiness, chronic cough and recurrent chest infections are among the wide variety of signs that are often attributed to gastro-oesophageal reflux disease (GORD). The difficulty lies in distinguishing between physiological gastro-oesophageal reflux (GOR) and GORD and none of the tests available can, alone, give conclusive evidence for the latter. Clinicians are often at a loss which investigation to request in order to assess for GOR and assist in a diagnosis of GORD. Our hypothesis was that GORD investigations at Red Cross War Memorial Children's Hospital (RCWMCH) are requested without considering the appropriate modality required and without clear indications for suspecting GORD. This was supported by practical experience and a short preliminary review of request forms. In South Africa no specific guidelines exist regarding the diagnosis of GORD and there is a poor understanding of available tests and their role in aiding the diagnosis. Thus many unnecessary tests are requested. To review how appropriate the requests for GORD investigations were we analysed all requests made to the departments of nuclear medicine and radiology at RCWMCH for the purpose of GORD investigation between January and April 2011. This analysis was based on a review of the folders and the data of tests performed on all included patients. The two examination modalities involved were gastro-oesophageal radionuclide scintigrams (commonly known as milk scans) and contrast swallows. The specific points assessed were reasonability of the request, appropriate timing of the investigation, use of the correct modality for the question investigated and lastly evaluation of prior treatment with antacids. We found that most of the studies performed were requested on appropriate grounds and that the timing of the majority of the investigations was reasonable. DA - 2015 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2015 T1 - Reasonability of gastro-oesophageal reflux study requests (contrast swallows and milk scans) for the detection of gastro-oesophageal reflux disease at Red Cross War Memorial Children's Hospital - a retrospective analysis TI - Reasonability of gastro-oesophageal reflux study requests (contrast swallows and milk scans) for the detection of gastro-oesophageal reflux disease at Red Cross War Memorial Children's Hospital - a retrospective analysis UR - http://hdl.handle.net/11427/16488 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/16488
dc.identifier.vancouvercitationBau S. Reasonability of gastro-oesophageal reflux study requests (contrast swallows and milk scans) for the detection of gastro-oesophageal reflux disease at Red Cross War Memorial Children's Hospital - a retrospective analysis. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Department of Paediatrics and Child Health, 2015 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/16488en_ZA
dc.language.isoengen_ZA
dc.publisher.departmentDepartment of Paediatrics and Child Healthen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherPaediatricsen_ZA
dc.titleReasonability of gastro-oesophageal reflux study requests (contrast swallows and milk scans) for the detection of gastro-oesophageal reflux disease at Red Cross War Memorial Children's Hospital - a retrospective analysisen_ZA
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMMeden_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceThesisen_ZA
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