Our new evidence-based review helps you answer the question: Should my endoscopy center test asymptomatic patients for SARS-CoV-2 prior to endoscopy?
- Read the AGA Institute Rapid Review and Recommendations on the Role of Pre-Procedure SARS-CoV2 Testing and Endoscopy, published in Gastroenterology.
- Join the authors for a live webinar Thursday, July 30, 7:30 p.m. EDT, to review the guidance. They’ll demo a new online tool that will help you determine the downstream effects of implementing a pretesting strategy based on your local prevalence and testing performance data.
- Ask the authors questions in a Roundtable event on the AGA Community. Follow the discussion to receive updates, like the link and instructions to the new online tool.
Key guidance for gastroenterologists
Endoscopy centers in areas with an intermediate prevalence of SARS-CoV-2 infection should consider testing patients for the virus before endoscopy. Several important factors contribute to this decision including testing feasibility, personal protective equipment (PPE) availability, and risk aversion threshold of endoscopists and staff.
Endoscopy centers in both low- and high-prevalence areas may not benefit from a pre-testing strategy.
- Rationale for low-prevalence areas: Diagnostic tests have a high proportion of false positives with significant downstream consequences, such as patient burden (quarantining and out of work for 14 days), unnecessarily delayed cases and over-utilization of testing which may already be limited in availability. Therefore, PPE availability may drive decision-making for case triage instead. If PPE is not limited, then the majority of endoscopists and staff may reasonable select to use N95/N99 respirators or PAPRs.
- Rationale for high-prevalence areas: Highest available PPE (such as N95/N99 respirators or PAPRs) would be used universally, as available. Additionally, testing is often limited due to a high demand for a potential surge of cases.
AGA created an online tool to help endoscopy centers make decisions about their pre-endoscopy testing strategy. This tool combines local prevalence with diagnostic test performance data to calculate the proportion of true versus false positives and negatives to help endoscopy centers understand the downstream consequences of implementing a pre-procedure testing strategy. View instructions for using the online tool.
For all four evidence-based recommendations and a detailed discussion, review the full publication in Gastroenterology.