{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T14:27:40Z","timestamp":1758637660179},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"894","license":[{"start":{"date-parts":[[2000,4,1]],"date-time":"2000-04-01T00:00:00Z","timestamp":954547200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2000,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Iron deficiency anaemia commonly presents in patients who are asymptomatic. In the absence of published guidelines the search for a cause in such cases is frequently uncoordinated, and risks delay in the diagnosis of pathologies requiring urgent attention. This audit was undertaken to determine how thoroughly patients referred to the gastrointestinal unit in a district general hospital between 1990 and 1995 had been investigated, and to draw up guidelines for future practice on the basis of its results. From the case notes of 334 patients examined endoscopically for anaemia 126 were identified as having both proved iron deficiency and a lack of clinical pointers to its cause. The percentage and details of diagnoses made during initial study and a median follow up period of 28 months were ascertained, together with the certified diagnoses of patients who had died. A cause of iron deficiency was identified in 48 (38%) of patients, 22 with cancer. Ten others received a diagnosis during follow up, of whom three died from the condition to which their anaemia had been attributed. Death certificates supplied diagnoses of potential relevance in three further cases. The main gaps in endoscopic coverage consisted of omitting duodenal biopsy or colonoscopy after negative upper gastrointestinal endoscopy. Moreover, diagnosis of certain extraintestinal pathologies, including cancers, was sometimes delayed for lack of liaison between gastroenterologists and other specialists. These and other points have been addressed in the guidelines now proposed.<\/jats:p>","DOI":"10.1136\/pmj.76.894.218","type":"journal-article","created":{"date-parts":[[2002,7,27]],"date-time":"2002-07-27T10:38:40Z","timestamp":1027766320000},"page":"218-222","source":"Crossref","is-referenced-by-count":15,"title":["Audit of the investigation of iron deficiency anaemia in a district general hospital, with sample guidelines for future practice"],"prefix":"10.1093","volume":"76","author":[{"given":"J M T","family":"Willoughby","sequence":"first","affiliation":[{"name":"Department of Medicine, Lister Hospital , Stevenage, Herts SG1 4AB, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S M","family":"Laitner","sequence":"additional","affiliation":[{"name":"Department of Medicine, Lister Hospital , Stevenage, Herts SG1 4AB, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2000,4,1]]},"reference":[{"key":"2023042614101411300_B1","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1111\/j.1445-5994.1979.tb04167.x","article-title":"Iron-deficiency anaemia\u2014a prospective study.","volume":"9","author":"Kerlin","year":"1979","journal-title":"Aust N Z J Med"},{"key":"2023042614101411300_B2","doi-asserted-by":"crossref","first-page":"1380","DOI":"10.1136\/bmj.292.6532.1380","article-title":"Gastrointestinal investigation of iron deficiency anaemia.","volume":"292","author":"Cook","year":"1986","journal-title":"BMJ"},{"key":"2023042614101411300_B3","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1093\/ageing\/16.6.399","article-title":"Gastrointestinal investigations for anaemia in the elderly: a prospective study.","volume":"16","author":"Calvey","year":"1987","journal-title":"Age Ageing"},{"key":"2023042614101411300_B4","doi-asserted-by":"crossref","first-page":"1102","DOI":"10.1136\/gut.34.8.1102","article-title":"Prospective survey of investigations in outpatients referred with iron deficiency anaemia.","volume":"34","author":"MacIntyre","year":"1993","journal-title":"Gut"},{"key":"2023042614101411300_B5","doi-asserted-by":"crossref","first-page":"1691","DOI":"10.1056\/NEJM199312023292303","article-title":"Evaluation of the gastrointestinal tract in patients with iron deficiency anemia.","volume":"329","author":"Rockey","year":"1993","journal-title":"N Engl J Med"},{"key":"2023042614101411300_B6","doi-asserted-by":"crossref","first-page":"1283","DOI":"10.1007\/BF02065539","article-title":"Prospective evaluation of gastrointestinal tract in patients with iron-deficiency anemia.","volume":"40","author":"Kepczyk","year":"1995","journal-title":"Dig Dis Sci"},{"key":"2023042614101411300_B7","first-page":"33","article-title":"Audit of the investigation and outcome of iron-deficiency anaemia in one health district.","volume":"30","author":"Lucas","year":"1996","journal-title":"J R Coll Physicians Lond"},{"key":"2023042614101411300_B8","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1007\/BF00320209","article-title":"Causes of iron deficiency anemia in an adult inpatient population. Effect of diagnostic workup on etiologic distribution.","volume":"49","author":"Hershko","year":"1984","journal-title":"Blut"},{"key":"2023042614101411300_B9","first-page":"1963","article-title":"The role of endoscopy in the evaluation of iron deficiency anemia in patients over the age of 50.","volume":"89","author":"Gordon","year":"1994","journal-title":"Am J Gastroenterol"},{"key":"2023042614101411300_B10","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1136\/bmj.314.7075.206","article-title":"Prevalence of concomitant disease in patients with iron deficiency anaemia.","volume":"314","author":"Till","year":"1997","journal-title":"BMJ"},{"key":"2023042614101411300_B11","first-page":"45","article-title":"Hypochromic anaemia: a retrospective study and follow-up of 378 in-patients.","volume":"34","author":"Beveridge","year":"1965","journal-title":"Q J Med"},{"key":"2023042614101411300_B12","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1136\/gut.38.1.120","article-title":"Use of whole gut perfusion to investigate gastrointestinal blood loss in patients with iron deficiency anaemia.","volume":"38","author":"Ferguson","year":"1996","journal-title":"Gut"},{"key":"2023042614101411300_B13","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1016\/S0002-9343(98)00260-5","article-title":"Evaluation of the gastrointestinal tract in premenopausal women with iron deficiency anemia.","volume":"105","author":"Bini","year":"1998","journal-title":"Am J Med"},{"key":"2023042614101411300_B14","doi-asserted-by":"crossref","first-page":"1738","DOI":"10.1136\/bmj.292.6537.1738-a","article-title":"Gastrointestinal investigations of iron deficiency anaemia (letter).","volume":"292","author":"Tobin","year":"1986","journal-title":"BMJ"},{"key":"2023042614101411300_B15","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1136\/gut.43.2.280","article-title":"Two way push videoenteroscopy in investigation of small bowel disease.","volume":"43","author":"Bouhnik","year":"1998","journal-title":"Gut"},{"key":"2023042614101411300_B16","first-page":"A88","article-title":"Investigation of iron deficiency anaemia\u2014a role for angiography (abstract).","volume":"41 (suppl 3)","author":"Lindsay","year":"1997","journal-title":"Gut"},{"key":"2023042614101411300_B17","doi-asserted-by":"crossref","first-page":"1427","DOI":"10.1136\/gut.34.10.1427","article-title":"Iron deficiency anaemia\u2014how far to investigate?","volume":"34","author":"Sahay","year":"1993","journal-title":"Gut"}],"container-title":["Postgraduate Medical Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/pmj\/article-pdf\/76\/894\/218\/50044162\/postgradmedj-76-218.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/pmj\/article-pdf\/76\/894\/218\/50044162\/postgradmedj-76-218.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,26]],"date-time":"2023-04-26T14:40:03Z","timestamp":1682520003000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/pmj\/article\/76\/894\/218\/7040080"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2000,4,1]]},"references-count":17,"journal-issue":{"issue":"894","published-online":{"date-parts":[[2000,4,1]]},"published-print":{"date-parts":[[2000,4,1]]}},"URL":"https:\/\/doi.org\/10.1136\/pmj.76.894.218","relation":{},"ISSN":["1469-0756","0032-5473"],"issn-type":[{"value":"1469-0756","type":"electronic"},{"value":"0032-5473","type":"print"}],"subject":[],"published-other":{"date-parts":[[2000,4]]},"published":{"date-parts":[[2000,4,1]]}}}