Will Screening Colonoscopy Disappear and Transform Gastroenterology Practice? Threats to Clinical Practice and Recommendations to Reduce Their Impact: Report of a Consensus Conference Conducted by the AGA Institute Future Trends Committee

Gastroenterology

Volumn 131, Issue 4, 2006, Pages 1287-1312

  Regueiro, Carol R ^a  

^a NONE

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; BIOTECHNOLOGY; CAPSULE ENDOSCOPY; CARDIOLOGY; CLINICAL ASSESSMENT; CLINICAL EFFECTIVENESS; CLINICAL PRACTICE; CLINICAL PROTOCOL; COLONOSCOPY; CONFOCAL MICROSCOPY; DIAGNOSTIC TEST; DIGESTIVE SYSTEM CANCER; DIGESTIVE SYSTEM FUNCTION DISORDER; ECONOMICS; ENDOSCOPE; ENDOSCOPIC SURGERY; FLUORESCENCE; GASTROENTEROLOGY; GASTROINTESTINAL MOTILITY; HEALTH CARE FACILITY; HEALTH CARE MANAGEMENT; HEALTH CARE MANPOWER; HEALTH CARE POLICY; HEPATITIS; HUMAN; IMAGE ENHANCEMENT; IMAGE QUALITY; IMAGING; INFORMATION PROCESSING; INFUSION; MAGNIFICATION RADIOGRAPHY; MEDICAL EDUCATION; MEDICAL INFORMATION; MEDICAL RECORD; MEDICAL SOCIETY; OBESITY; OPTICAL COHERENCE TOMOGRAPHY; PATIENT CARE; PRIORITY JOURNAL; SCREENING; SPECTROSCOPY;

EID: 33749339483     PISSN: 00165085     EISSN: None     Source Type: Journal    
DOI: 10.1053/j.gastro.2006.08.017     Document Type: Article

References (109)

1. The Institute for Health & Aging, University of California, San Francisco. Chronic care in America: A 21st century challenge (1996), The Robert Wood Johnson Foundation, Princeton, NJ August
2. Hoffman C., Rice D., and Sung M.Y. Persons with chronic conditions: their prevalence and costs. JAMA 276 (1997) 1473-1479
3. Medicare beneficiary demographics. Available at: http://www.medpac.gov/publications/congressional_reports/Jun04DataBookSec1.pdf. Accessed June 25, 2006.
4. The 2004 annual report of the board of the trustees of the federal old-age survivors insurance and disability insurance trust funds. Available at: http://www.ssa.gov/OACT/TR/TR04/trTOC.html. Accessed June 25, 2006.
5. Increased use of colorectal cancer tests in the US. MMWR 55 (2006) 308-311
6. Smith C., Cowan C., Sensenig A., and Catlin A. Health spending growth slows in 2004. Health Aff 25 (2006) 186-196
7. Borger C., Smith S., Truffer C., Keehan S., Sisko A., Poisal J., and Clemens M.K. Health spending projections through 2015: changes on the horizon. Health Aff (Millwood) 25 (2006) w61-w73
8. The Henry J. Kaiser Family Foundation. Employee health benefits: 2005 annual survey (2005), The Henry J. Kaiser Family Foundation, Menlo Park, CA September
9. Wilson KB. Snapshot: health care costs 101, 2006 edition, March 2006. California Health Care Foundation. Available at: http://www.chcf.org/topics/healthinsurance/index.cfm?itemID=119856. Accessed June 25, 2006.
10. Hewitt Associates LLC. Health care expectations: future strategy and direction 2005. Hewitt Associates LLC, November 17, 2004. Available at: http://www.hewittassociates.com/_MetaBasicCMAssetCache_/Assets/Articles/11-17-04_exec.pdf.
11. Agency for Healthcare Research and Quality. Out-of-pocket expenditures on health care and insurance premiums among the non-elderly population, 2003, March 2006. MEPS Statistical Brief no. 121 available at http://meps.ahrq.gov/papers/st121/stat121.pdf.
12. Estimated sustainable growth rate and conversion factor, for Medicare payments to physicians in 2006. Available at: http://www.cms.hhs.gov/SustainableGRatesConFact/Downloads/sgr2006f.pdf. Accessed June 25, 2006.
13. Estimated sustainable growth rate and conversion factor, for Medicare payments to physicians in 2007. Available at: http://www.cms.hhs.gov/SustainableGRatesConFact/Downloads/MedPAC_Letter_Estimated_2007.pdf. Accessed June 25, 2006.
14. Social Security and Medicare Boards of Trustees. Status of the social security and Medicare programs: a summary of the 2006 annual reports. Available at: http://www.ssa.gov/OACT/TRSUM/tr06summary.pdf. Accessed June 25, 2006.
15. The 2006 annual report of the board of trustees of the federal old-age and survivors insurance and disability insurance trust funds. Available at: http://www.ssa.gov/OACT/TR/TR06/index.html. Accessed June 25, 2006.
16. Maxwell S., Zuckerman S., and Aliaga P. Effects of the implementation of resource-based practice expense relative value units under the Medicare physician fee schedule, 1998-2002 (final report to MedPAC) (2004), The Urban Institute, Washington, DC
17. Rand Corporation. Services provided in multiple ambulatory settings: a comparison of selected procedures. Available at: http://www.aaasc.org/advocacy/documents/Randreport1104_000.pdf. Accessed June 25, 2006.
18. Winter A. Comparing the mix of patients in various outpatient surgery settings. Health Aff (Millwood) 22 (2003) 68-73
19. Overview of the State Ambulatory Surgery Databases (SASD). Available at: http://www.hcup-us.ahrq.gov/sasdoverview.jsp. Accessed June 25, 2006.
20. Summary of the Ambulatory Surgical Center Medicare Payment Modernization Act. Available at: http://www.fasa.org/ASCPaymentModernizationActSummaryandFacts.pdf. Accessed June 25, 2006.
21. Personal communication, Dr Joel V. Brill, based on comparison of Medicare fee schedules for commonly performed endoscopic procedures in the hospital, outpatient and ambulatory surgery center settings. Available at: http://www.cms.hhs.gov/ASCPayment/, http://www.cms.hhs.gov/PhysicianFeeSched/, and http://www.cms.hhs.gov/HospitalOutpatientPPS/. Accessed April 1, 2006.
22. Personal communication, Dr Joel V. Brill, based on http://www.fasa.org/ascreform.htm, http://www.fasa.org/ASCPaymentModernizationActSummaryandFacts.pdf, and http://www.fasa.org/S1884.pdf. Accessed April 1, 2006.
23. Urban Institute analysis of CMS physician/supplier files and AMA RUC review files. Available at: http://www.medpac.gov/publications/congressional_reports/Dec04_PhysExpense.pdf. Accessed June 25, 2006.
24. Reviewing the work relative values of physicians fee schedules services. Available at: http://www.medpac.gov/publications/congressional_reports/Mar06_Ch03.pdf. Accessed June 25, 2006.
25. Reinhardt U.E. Does the aging of the population really drive the demand for health care?. Health Aff 22 (2003) 27-39
26. Strunk B.C., and Ginsburg P.B. Aging plays limited role in health care cost trends. Data Bull 23 (2002) 1-2
27. Lieberman D.A., Fennerty M.B., Morris C., Holub J., and Sonnenberg A. Endoscopic evaluation of patients with dyspepsia: results from the national endoscopic data repository. Gastroenterology 127 (2004) 1067-1075
28. Lieberman D.A., Holub J., Eisen G., Kraemer D., and Morris C.D. Utilization of colonoscopy in the United States: results from a national consortium. Gastrointest Endosc 62 (2005) 875-883
29. Lieberman D.A., Weiss D.G., Bond J.H., and Veterans Affairs Cooperative Study Group 380. Use of colonoscopy to screen asymptomatic adults for colorectal cancer. N Engl J Med 343 (2000) 162-168
30. Winawer S.J., Zauber A.G., Ho M.N., O'Brien M.J., Gottlieb L.S., Sternberg S.S., Waye J.D., Schapiro M., Bond J.H., Panish J.F., et al., The National Polyp Study Workgroup. Prevention of colorectal cancer by colonoscopic polypectomy. N Engl J Med 329 (1993) 1977-1981
31. Schatzkin A., Lanza E., Corle D., Lance P., Iber F., Caan B., Shike M., Weissfeld J., Burt R., Cooper M.R., Kikendall J.W., Cahill J., and Polyp Prevention Trial Study Group. Lack of effect of a low-fat, high-fiber diet on the recurrence of colorectal adenomas. N Engl J Med 342 (2000) 1149-1155
32. Alberts D.S., Martinez M.E., Roe D.J., Guillen-Rodriguez J.M., Marshall J.R., van Leeuwen J.B., Reid M.E., Ritenbaugh C., Vargas P.A., Bhattacharyya A.B., Earnest D.L., Sampliner R.E., and Phoenix Colon Cancer Prevention Physicians' Network. Lack of effect of a high-fiber cereal supplement on the recurrence of colorectal adenomas. N Engl J Med 342 (2000) 1156-1162
33. Robertson D.J., Greenberg E.R., Beach M., Sandler R.S., Ahnen D., Haile R.W., Burke C.A., Snover D.C., Bresalier R.S., McKeown-Eyssen G., Mandel J.S., Bond J.H., Van Stolk R.U., Summers R.W., Rothstein R., Church T.R., Cole B.F., Byers T., Mott L., and Baron J.A. Colorectal cancer in patients under close colonoscopic surveillance. Gastroenterology 129 (2005) 34-41
34. Lieberman D.A., and Weiss D. 5-year surveillance of patients with adenomas or colorectal cancer at screening colonoscopy: results from the VA Cooperative Study #380 (abstr). Gastroenterology 126 (2004) A-22
35. Pickhardt P.J., Nugent P.A., Mysliwiec P.A., Choi J.R., and Schindler W.R. The adenoma miss rate at optical colonoscopy: a novel assessment using virtual colonoscopy as a separate reference standard. Ann Intern Med 141 (2004) 352-359
36. Cotton P.B., Durkalski V.L., Pineau B.C., Palesch Y.Y., Mauldin P.D., Hoffman B., Vining D.J., Small W.C., Affronti J., Rex D., Kopecky K.K., Ackerman S., Burdick J.S., Brewington C., Turner M.A., Zfass A., Wright A.R., Iyer R.B., Lynch P., Sivak M.V., and Butler H. Computed tomographic colonography (virtual colonoscopy): a multicenter comparison with standard colonoscopy for detection of colorectal neoplasms. JAMA 291 (2004) 1713-1719
37. Rockey D.C., Paulson E., Niedzwiecki D., Davis W., Bosworth H.B., Sanders L., Yee J., Henderson J., Hatten P., Burdick S., Sanyal A., Rubin D.T., Sterling M., Akerkar G., Bhutani M.S., Binmoeller K., Garvie J., Bini E.J., McQuaid K., Foster W.L., Thompson W.M., Dachman A., and Halvorsen R. Analysis of air contrast barium enema, computed tomographic colonography and colonoscopy: prospective comparison. Lancet 365 (2005) 305-311
38. Centers for Disease Control and Prevention. Trends in screening for colorectal cancer-United States, 1997 and 1999. Morb Mortal Wkly Rep 50 (2001) 162-166
39. Vernon S.W. Participation in colorectal cancer screening: a review. J Natl Cancer Inst 89 (1997) 1406-1422
40. Lieberman D.A., Weiss D.G., and VA Cooperative Study #380 Group. One-time screening for colorectal cancer with combined fecal occult-blood test and examination of the distal colon. N Engl J Med 345 (2001) 555-560
41. Imperiale T.F., Ransohoff D.E., Itzkowitz S.H., Turnbull B.A., Ross M.E., and Colorectal Cancer Study Group. Fecal DNA vs. fecal occult blood for colorectal cancer screening in an average-risk population. N Engl J Med 351 (2004) 2704-2714
42. Young G.P., St. John J.B., Winawer S.J., and Rozen P. Choice of fecal occult blood tests for colorectal cancer screening: recommendations based on performance characteristics in population studies. Am J Gastroenterol 97 (2002) 2499-2507
43. Morikawa T., Kato J., Yamaji Y.M., Wada R., Mitsushima T., and Shiratori Y. A comparison of immunochemical fecal occult blood test and total colonoscopy in the asymptomatic population. Gastroenterology 129 (2005) 422-428
44. Ahlquist D.A. Stool-based DNA tests for colorectal cancer: clinical potential and early results. Rev Gastroenterol Disord 2 suppl 1 (2002) S20-S26
45. Ahlquist D.A., Skoletsky J.E., Boynton K.A., Harrington J.J., Mahoney D.W., Pierceall W.E., Thibodeau S.N., and Shuber A.P. Colorectal cancer screening by detection of altered DNA in stool: feasibility of a multitarget assay panel. Gastroenterology 119 (2000) 1219-1227
46. Traverso G., Shuber A., Levin B., Johnson C., Olsson L., Schoetz Jr. D.J., Hamilton S.R., Boynton K., Kinzler K.W., and Vogelstein B. Detection of APC mutations in fecal DNA from patients with colorectal tumors. N Engl J Med 346 (2002) 311-320
47. Dong S.M., Traverso G., Johnson C., Geng L., Favis R., Boynton K., Hibi K., Goodman S.N., D'Allessio M., Paty P., Hamilton S.R., Sidransky D., Barany F., Levin B., Shuber A., Kinzler K.W., Vogelstein B., and Jen J. Detecting colorectal cancer in stool with the use of multiple genetic targets. J Natl Cancer Inst 93 (2001) 858-865
48. Brand R.E., Ross M.E., and Shuber A.P. Reproducibility of a multitarget stool-based DNA assay for colorectal cancer detection. Am J Gastroenterol 99 (2004) 1338-1341
49. Tagore K.S., Lawson M.J., Yucaitis J.A., Gage R., Orr T., Shuber A.P., and Ross M.E. Sensitivity and specificity of a stool DNA multitarget assay panel for the detection of advanced colorectal neoplasia. Clin Colorectal Cancer 3 (2003) 47-53
50. Syngal S., Chung D., Willet C., et al. Stool DNA analysis for the detection and follow-up of colorectal cancer and advanced adenomas: sensitivity in a prospective series (abstr). Am J Gastroenterol 97 suppl (2002) S109
51. Calistri D., Rengucci C., Bocchini R., Saragoni L., Zoli W., and Amadori D. Fecal multiple molecular tests to detect colorectal cancer in stool. Clin Gastroenterol Hepatol 1 (2003) 377-383
52. Ouyang D.L., Chen J.J., Getzenberg R.H., and Schoen R.E. Non-invasive testing for colorectal cancer: a review. Am J Gastroenterol 100 (2005) 1393-1403
53. Iannaccone R., Laghi A., Catalano C., Mangiapane F., Lamazza A., Schillaci A., Sinibaldi G., Murakami T., Sammartino P., Hori M., Piacentini F., Nofroni I., Stipa V., and Passariello R. Computed tomographic colonography without cathartic preparation for the detection of colorectal polyps. Gastroenterology 127 (2004) 1300-1311
54. Fidler J.L., Johnson C.D., MacCarty R.L., Welch T.J., Hara A.K., and Harmsen W.S. Detection of flat lesions in the colon with CT colonography. Abdom Imaging 27 (2002) 292-3000
55. Pickhardt P.J., Nugent P.A., Choi J.R., and Schindler W.R. Flat colorectal lesions in asymptomatic adults: implications for screening with CT colonography. AJR Am J Roentgenol 183 (2004) 1343-1347
56. Pickhardt P.J., Choi J.R., Hwang I., Butler J.A., Puckett M.L., Hildebrandt J.A., Wong R.K., Nugent P.A., Mysliwiec P.A., and Schlinder W.R. Computed tomographic virtual colonoscopy to screen for colorectal neoplasia in asymptomatic adults. N Engl J Med 349 (2003) 2191-2200
57. Mulhall B.P., Veerappan G.R., and Jackson J.L. Meta-analysis: computed tomographic colonography. Ann Intern Med 142 (2005) 635-650
58. Zalis M.E., Barish M.A., Choi J.R., Dachman A.H., Fenlon H.M., Ferrucci J.T., Glick S.N., Laghi A., Macari M., McFarland E.G., Morrin M.M., Pickhardt P.J., Soto J., Yee J., and Working Group on Virtual Colonoscopy. CT colonography reporting and data system: a consensus proposal. Radiology 236 (2005) 3-9
59. Glick SN, Macari M, Johnson CD, Yee J. ACR practice guidelines for the performance of computed tomography in adults (effective October 1, 2005). Available from the American College of Radiology, Reston, VA 20191.
60. Hara A.K., Johnson C.D., MacCarty R.L., and Welch T.J. Incidental extracolonic findings at CT colonography. Radiology 215 (2000) 353-357
61. Gluecker T.M., Johnson C.D., Wilson L.A., MacCarthy R.L., Welch T.J., Vanness D.J., and Ahlquist D.A. Extra-colonic findings at CT colonography: evaluation of prevalence and cost in a screening population. Gastroenterology 124 (2003) 911-916
62. Yee J., Kumar N.N., Godara S., Casamina J.A., Hom R., Galdino G., Dell P., and Liu D. Extracolonic abnormalities discovered incidentally at CT colonography in a male population. Radiology 236 (2005) 519-526
63. Rajapaska R.C., Macari M., and Bini E.J. Prevalence and impact of extracolonic findings in patients undergoing CT colonography. J Clin Gastroenterol 38 (2004) 767-771
64. Pfeffer J., Grinshpon R., Rex D., Levin B., Rosch T., Arber N., and Halpern Z. The Aer-O-Scope: proof of the concept of a pneumatic, skill-independent, self-propelling, self-navigating colonoscope in a pig model. Endoscopy 38 (2006) 144-148
65. Song L.W.K., and Wilson B.C. Endoscopic detection of early upper GI cancers. Best Pract Res Clin Gastroenterol 19 (2005) 833-856
66. Pfau P.R., and Sivak M.V. Endoscopic diagnostics. Gastroenterology 120 (2001) 763-781
67. Kumagai Y., Monma K., and Kawada K. Magnifying chromoendoscopy of the esophagus: in-vivo pathological diagnosis using an endocystoscopy system. Endoscopy 36 (2004) 590-594
68. Wang T.D., and Van Dam J. Optical biopsy: a new frontier in endoscopic detection and diagnosis. Clin Gastroenterol Hepatol 2 (2004) 744-753
69. Inoue H., Kudo S.E., and Shiokawa A. Technology insight: laser-scanning confocal microscopy and endocytoscopy for cellular observation of the gastrointestinal tract. Nat Clin Pract Gastroenterol Hepatol 2 (2005) 31-37
70. Lambert R., and Sharma P. Paris Workshop on Columnar Metaplasia. Endoscopy 37 (2005) 879-920
71. Marten K., Bremer C., Khazaie K., Sameni M., Sloane B., Tung C.H., and Weissleder R. Detection of dysplastic intestinal adenomas using enzyme-sensing molecular beacons in mice. Gastroenterology 122 (2002) 406-414
72. Roy H.K., Liu Y., Wali R.K., Kim Y.L., Kromine A.K., Goldberg M.J., and Backman V. Four-dimensional elastic light-scattering fingerprints as preneoplastic markers in the rat model of colon carcinogenesis. Gastroenterology 126 (2004) 1071-1081
73. Dacosta R.S., Wilson B.C., and Marcon N.E. Optical techniques for the endoscopic detection of dysplastic colonic lesions. Curr Opin Gastroenterol 21 (2005) 70-79
74. Kiesslich R., Burg J., Vieth M., Gnaendiger J., Enders M., Delaney P., Polglase A., McLaren W., Janell D., Thomas S., Nafe B., Galle P.R., and Neurath M.F. Confocal laser endoscopy for diagnosing intraepithelial neoplasia and colorectal cancer in vivo. Gastroenterology 127 (2004) 706-713
75. Personal communication, Dr Anthony DiMarino, April 1, 1006, based on information from the American Gastroenterology Chiefs of GI Surveys 2004 and 2005.
76. Hanauer SB. Is it payback time? Private practices should pay academic medical centers to train their future partners. Available at: http://www.gastro.org/wmspage.cfm?parm1=1686. Accessed April 19, 2006.
77. Natural Orifice Surgery Consortium for Assessment and Research (NOSCAR). Available at: http://www.noscar.org.
78. Kalloo A.N., Singh V.K., Jagannath S.B., Niiyama H., Hill S.L., Vaughn C.A., Magee C.A., and Kantsevoy S.V. Flexible transgastric peritoneoscopy: a novel approach to diagnostic and therapeutic interventions in the peritoneal cavity. Gastrointest Endosc 60 (2004) 114-117
79. Kantsevoy S.V., Jagannath S.B., Niiyama H., Chung S.S., Cotton P.B., Gostout C.J., Hawes R.H., Pasricha P.J., Magee C.A., Vaughn C.A., Barlow D., Shimonaka H., and Kalloo A.N. Endoscopic gastrojejunostomy with long-term survival in a porcine model. Gastrointest Endosc 62 (2005) 287-292
80. Jagannath S.B., Kantsevoy S.V., Vaughn C.A., Chung S.S., Cotton P.B., Gostout C.J., Hawes R.H., Pasricha P.J., Scorpio D.G., Magee C.A., Pipitone L.J., and Kalloo A.N. Peroral transgastric endoscopic ligation of fallopian tubes with long-term survival in a porcine model. Gastrointest Endosc 61 (2005) 449-453
81. Kantsevoy S.V., Hu B., Jagannath S.B., Vaughn C.A., Beitler D.M., Chung S.S., Cotton P.B., Gostout C.J., Hawes R.H., Pasricha P.J., Magee C.A., Pipitone L.J., Talamini M.A., and Kalloo A.N. Transgastric endoscopic splenectomy: is it possible?. Surg Endosc 20 (2006) 522-555
82. Ko C.W., and Kalloo A.N. Per-oral transgastric abdominal surgery. Chin J Dig Dis 7 (2006) 67-70
83. Sturm R. Increases in clinically severe obesity in the United States, 1986-2000. Arch Intern Med 163 (2003) 2146-2148
84. Buchwald H., Avidor Y., Braunwald E., Jensen M.D., Pories W., Fahrbach K., and Schoelles K. Bariatric surgery: a systematic review and meta-analysis. JAMA 292 (2004) 1724-1737
85. Steinbrook R. Surgery for severe obesity. N Engl J Med 350 (2004) 1075-1079
86. Kaplan L.M., Fallon J.A., Mun E.C., Harvey A.M., Kastrinakis W.V., Johnson E.Q., Nierman R.S., and Keroack C.R. Coding and reimbursement for weight loss surgery: best practice recommendations. Obes Res 13 (2005) 290-300
87. Kaplan L.M. Body weight regulation and obesity. J Gastrointest Surg 7 (2003) 443-451
88. Personal communication, Dr Lee Kaplan, April 1, 2006.
89. Winawer SJ. Results of an OMGE international survey: the role of the gastroenterologist in the management of patients with gastrointestinal cancers. World Gastroenterology News 2004;9.
90. Davis G.L., Albright J.E., Cook S., and Rosenberg D. Projecting the future healthcare burden from hepatitis C in the United States. Hepatology 28 (1998) 390A
91. Davis G.L., Albright J.E., Cook S.F., and Rosenberg D.M. Projecting future complications of chronic hepatitis C in the United States. Liver Transpl 9 (2003) 331-338
92. Bryant R., and Graham M.C. Advanced practice nurses: a study of client satisfaction. J Am Acad Nurse Pract 14 (2002) 88-92
93. Mundinger M.O., Kane R.L., Lenz E.R., Totten A.M., Tsai W.Y., Cleary P.D., Friedewald W.T., Siu A.L., and Shelanski M.L. Primary care outcomes in patients treated by nurse practitioners or physicians: a randomized trial. JAMA 283 (2000) 59-68
94. Drossman D.A., Li Z., Andruzzi E., Temple R.D., Talley N.J., Thompson W.G., Whitehead W.E., Janssens J., Funch-Jensen P., Corazziari E., et al. U.S. householder survey of functional gastrointestinal disorders: prevalence, sociodemography, and health impact. Dig Dis Sci 38 (1993) 1569-1580
95. Camilleri M., Dubois D., Coulie B., Jones M., Kahrilas P.J., Rentz A.M., Sonnenberg A., Stanghellini V., Stewart W.F., Tack J., Talley N.J., Whitehead W., and Revicki D.A. Prevalence and socioeconomic impact of upper gastrointestinal disorders in the United States: results of the US Upper Gastrointestinal Study. Clin Gastroenterol Hepatol 3 (2005) 543-552
96. Chang L. Epidemiology and quality of life in functional gastrointestinal disorders. Aliment Pharmacol Ther 20 suppl 7 (2004) 31-39
97. Russo M.W., Wei J.T., Thiny M.T., Gangarosa L.M., Brown A., Ringel Y., Shaheen N.J., and Sandler R.S. Digestive and liver statistics, 2004. Gastroenterology 126 (2004) 1448-1453
98. Personal communication, Dr Fabio Cominelli.
99. Medicare prescription drug coverage enrollment update. Available at: http://www.kff.org/medicare/upload/7453.pdf. Accessed June 25, 2006.
100. CMS news release. 30 million Medicare beneficiaries now receiving prescription drug coverage. Available at: http://hhs.gov/news/press/2006pres/20060420.html. Accessed June 25, 2006.
101. Medicare Part D, total beneficiaries coverage. Available at: http://www.cms.hhs.gov/PrescriptionDrugCovGenIn/Downloads/PartDTotalBeneficiariesCoverage.zip. Accessed June 25, 2006.
102. Medicare Part D, state enrollment. Available at: http://www.cms.hhs.gov/PrescriptionDrugCovGenIn/Downloads/PartDStateEnrollmentData.zip. Accessed June 25, 2006.
103. 42 USC Section 1395.
104. 1998 Federal Register. November 2, 1999, p 59433.
105. 1999 Federal Register. November 1, 2000, p 65435.
106. 2000 Federal Register. November 1, 2001, p 55323.
107. 2001 Federal Register. December 31, 2002, p 80035.
108. 2002 Federal Register. November 7, 2003, p 63255.
109. 2003 Federal Register. November 15, 2004, p 66395.