Asian Perspectives on Diagnostic and Therapeutic Strategies in Inflammatory Bowel Disease: Report and Analysis of a Survey with Questionnaires

Atsushi Yoshida, Fumiaki Ueno, Toshio Morizane, Takashi Joh, Takeshi Kamiya, Shin"ichi Takahashi, Kengo Tokunaga, Ryuichi Iwakiri, Yoshikazu Kinoshita, Hidekazu Suzuki, Yuji Naito, Kazuhiko Uchiyama, Shin Fukodo, Francis K.L. Chan, Ki Baik Halm, Udom Kachintorn, Kwong Ming Fock, Abdul Aziz Rani, Ari Fahrial Syam, Jose D. SollanoQi Zhu

Research output: Contribution to journalReview articlepeer-review

Abstract

Background: Diagnostic and therapeutic strategies in inflammatory bowel disease (IBD) vary among countries in terms of availability of modalities, affordability of health care resource, health care policy and cultural background. This may be the case in different countries in Eastern Asia. The aim of this study was to determine and understand the differences in diagnostic and therapeutic strategies of IBD between Japan and the rest of Asian countries (ROA). Methods: Questionnaires with regard to clinical practice in IBD were distributed to members of the International Gastroenterology Consensus Symposium Study Group. The responders were allowed to select multiple items for each question, as multiple modalities are frequently utilized in the diagnosis and the management of IBD. Dependency and independency of selected items for each question were evaluated by the Bayesian network analysis. Results: The selected diagnostic modalities were not very different between Japan and ROA, except for those related to small bowel investigations. Balloon-assisted enteroscopy and small bowel follow through are frequently used in Japan, while CT/MR enterography is popular in ROA. Therapeutic modalities for IBD depend on availability of such modalities in clinical practice. As far as modalities commonly available in both regions are concerned, there seemed to be similarity in the selection of each therapeutic modality. However, evaluation of dependency of separate therapeutic modalities by Bayesian network analysis disclosed some difference in therapeutic strategies between Japan and ROA. Conclusion: Although selected modalities showed some similarity, Bayesian network analysis elicited certain differences in the clinical approaches combining multiple modalities in various aspects of IBD between Japan and ROA.

Original languageEnglish
Pages (from-to)79-88
Number of pages10
JournalDigestion
Volume95
Issue number1
DOIs
Publication statusPublished - 1 Jan 2017

Keywords

  • Bayesian network
  • Crohn's disease
  • Diagnosis
  • Inflammatory bowel disease
  • Management
  • Ulcerative colitis

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