Calc Function

  • Diagnosis
  • Rule Out
  • Prognosis
  • Formula
  • Treatment
  • Algorithm
  • Disease
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    Specialty
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    Chief Complaint
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    Organ System
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    Diagnosis and Management of Small Bowel Bleeding

    Official guideline from the American College of Gastroenterology.

    summary by Vineet Rolston, MD Shannon Chang, MD

    Diagnosis: Endoscopy

    Second Look

    Strong recommendation
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    Low quality evidence

    Conditional recommendation
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    Very low quality evidence

    Strong recommendation
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    Moderate quality evidence

    Push Enteroscopy

    Conditional recommendation
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    Moderate quality evidence

    Strong recommendation
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    Very low quality evidence

    Video Capsule Endoscopy (VCE)

    Strong recommendation
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    Moderate quality evidence

    Strong recommendation
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    High quality evidence

    Total Deep Enteroscopy, Intraoperative Enteroscopy

    Strong recommendation
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    Moderate quality evidence

    Strong recommendation
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    High quality evidence

    Strong recommendation
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    Low quality evidence

    Diagnosis: Imaging

    CT Enterography

    Strong recommendation
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    Low quality evidence

    Conditional recommendation
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    Very low quality evidence

    Conditional recommendation
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    Very low quality evidence

    Conditional recommendation
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    Very low quality evidence

    CT Angiography

    Strong recommendation
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    Low quality evidence

    Conditional recommendation
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    Very low quality evidence

    Conventional Angiography

    Strong recommendation
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    Low quality evidence

    Conditional recommendation
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    Very low quality evidence

    Conditional recommendation
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    Very low quality evidence

    Tagged RBC

    Strong recommendation
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    Moderate quality evidence

    Meckel’s Scan

    Conditional recommendation
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    Very low quality evidence

    Barium

    Strong recommendation
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    High quality evidence

    Treatment

    Endoscopic Therapy

    Strong recommendation
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    Low quality evidence

    Medical Therapy

    Strong recommendation
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    Very low quality evidence

    Strong recommendation
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    Moderate quality evidence

    Persistent Bleeding, Recurrence

    Strong recommendation
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    Low quality evidence

    Conditional recommendation
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    Moderate quality evidence

    Surgery

    Strong recommendation
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    Low quality evidence

    Conditional recommendation
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    Low quality evidence

    Anticoagulants/Antiplatelets

    Conditional recommendation
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    Very low quality evidence

    Heyde’s Syndrome

    Conditional recommendation
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    Moderate quality evidence

    How strong is the ACG's recommendation?

    Strong recommendation
    Intervention's desirable effects clearly outweigh undesirable effects.
    Moderate recommendation
    Further research likely to impact confidence in estimate of effect.
    Conditional recommendation
    Uncertainty in tradeoffs between desirable & undesirable effects of intervention.
    Uncertainty in tradeoffs between desirable & undesirable effects of intervention.
    High quality evidence
    Further research unlikely to change guideline authors' confidence in estimate of effect.
    Between high and moderate levels of evidence.
    Moderate quality evidence
    Further research likely to impact confidence in estimate of effect.
    Low quality evidence
    Further research expected to have important impact in confidence in estimate of effect.
    Very low quality evidence
    Effect is very uncertain.