VALUABLE advances in the diagnosis of aerodigestive conditions have been made with the introduction of a new integrated framework. In this ever-evolving discipline, researchers across the United States have concluded that the process of multidisciplinary diagnosis offers patients, particularly children with conditions affecting growth, breathing, and swallowing, multiple benefits.
Paediatric centres which specialise in aerodigestive disorders can be found in 32 states across the USA. A study carried out in 2017 by the Children’s National Medical Center in Washington, D.C., USA, discovered that alongside improved outcomes, integrated care also reduces cost. Investigators found that in 73% of cases, the approach generated visible improvements in the symptoms of patients who had already been seen by a specialist, or brought about a resolution.
Multidisciplinary care allows professionals to combine investigations into one procedure, reducing the need for multiple invasive processes performed under anaesthesia. This ensures that paediatric patients undergo less stress and uncertainty, and can receive the treatment they require in less time. One procedure which has proven to be of great benefit is the ‘triple scope’, which includes a rigid bronchoscopy, a flexible bronchoscopy and bronchoalveolar lavage, and an endoscopy encompassing guided biopsies. The triple scope works across three disciplines – otolaryngology, pulmonology, and gastroenterology – and allows specialists to diagnose conditions which could be missed with a series of singular procedures.
In Massachusetts, USA, researchers concluded that of the 243 patients who underwent the triple scope, 83.5% had at least one confirmed condition, 41.5% were found to have a diagnosis specific to one single specialty, and 42% were given multiple diagnoses across disciplines. The conditions which were most frequently identified using the triple endoscopy procedure were duodenitis, gastritis, non-eosinophilic oesophagitis, eosinophilic oesophagitis, and reactive oesophageal changes.
President of the North American Society for Pediatric Gastroenterology, Hepatology & Nutrition (NASPGHAN), Benjamin Gold, praised this novel approach. He stated: “Patients can see the gastroenterologist, the pulmonologist, the [ear, nose and throat] specialist, the speech therapist and the dietitian all at one visit, and at the end of the clinic day, the whole team confers about the patient and develops a consensus, overall care plan.”