Examines the appropriateness in diagnostic yield of upper gastrointestinal endoscopy in an open-access endoscopy unit. It is based on the Switzerland study of 450 consecutive upper gastrointestinal endoscopies that were examined prospectively. About 57% of the endoscopies were judged to be appropriate . In about 90% of the endoscopies judged to be inappropriate, the reason was that the patients had not undergone empirical anti-ulcer therapy before endoscopy. The probability of finding a significant lesion did not differ between endoscopies judged to be appropriate and those judged to be inappropriate. This article concludes that in Switzerland, upper gastrointestinal endoscopy is used frequently for inappropriate indications and the main reason for inappropriate use is insufficient or no treatment of dyspeptic symptoms prior to endoscopy.
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