Development and validation of a web-based electronic application in managing antithrombotic agents in patients undergoing GI endoscopy.
Antithrombotics; Electronic Application; Endoscopy
BACKGROUND AND AIMS: Antithrombotic therapy among patients undergoing GI procedures is frequently encountered and can impact the procedure and patient outcomes. American Society for Gastrointestinal Endoscopy (ASGE) guidelines help to manage these medications before endoscopy depending on the patient's clinical status and the type of GI procedure. However, currently there is no readily available electronic tool that can assist in decision making regarding preprocedural management of these agents. Our aim was to develop an electronic application (ENDOAID) to help manage antithrombotic agents before endoscopy and to perform a validation study to test its accuracy.
RESULTS: There was a total of 208 simulated encounters, including 26 procedures. Initial concordance between ENDOAID recommendations and the criterion standard was seen in 206 encounters (99.03%). The 2 encounters that needed further review occurred among patients with Factor V Leiden mutation and DVT from APLA syndrome, and who were undergoing high-risk procedures that had ambiguous guidelines. ENDOAID suggested consultations with an expert before the elective procedure. This suggestion was agreed upon by expert endoscopist consensus. Thus, ENDOAID showed a 100% concordance with the ASGE guideline for managing antithrombotics. There was a high degree of correlation (r = 0.996, p < 0.01) between ENDOAID results with ASGE.
CONCLUSION: We have developed and validated an easy-to-use web-based application that can help in periprocedural management of antithrombotics. Such an application has the potential to simplify the management of these agents and potentially prevent procedural delays, cancellations, or unnecessary consults.
Swedish Digestive Health Institute
Nutalapati, Venkat; Tokala, Krishna Teja; Desai, Madhav; Kanakadandi, Vijay; Olyaee, Mojtaba; Parasa, Sravanthi; and Rastogi, Amit, "Development and validation of a web-based electronic application in managing antithrombotic agents in patients undergoing GI endoscopy." (2019). Articles, Abstracts, and Reports. 1698.