Cost-Effectiveness of Endoscopic Ultrasound Guided Tissue Sampling Techniques for the Diagnosis of Pancreatic and Intra-abdominal Mass Lesions

Imagine the stress of being told you might have cancer and then undergoing an invasive procedure to diagnose it, only to find out that the samples collected were not adequate and the procedure has to be repeated. Our project aims to determine the optimal strategy for gastroenterologists to help diagnose many diseases, including cancers, by obtaining a tissue sample that can be reviewed by a pathologist. Currently there are two methods utilized, which both use endoscopic ultrasound guidance: fine needle aspiration (FNA) which is the gold standard, and a new method called fine needle biopsy (FNB). We are performing the largest study to date to compare these different strategies. After collecting data from all patients who underwent one of these procedures over a 5-year period, we will perform advanced statistical modeling to determine the strategy that will optimize costs and patient outcomes. The ideal strategy will obtain an accurate diagnosis and minimize occurrences in which the patient must undergo repeat invasive procedures. Once identified, our strategy could then be implemented throughout the Northwestern Digestive Health Center to enhance patient care.