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Canadian Journal of Gastroenterology and Hepatology
Volume 29, Issue 7, Pages 373-376
http://dx.doi.org/10.1155/2015/672853
Original Article

Transient Elastography in Canada: Current State and Future Directions

Mohammed Aljawad,1,2 Sanjeev Sirpal,3,4 Eric M Yoshida,5 and Natasha Chandok1,3

1Department of Medicine, Western University, London, Ontario, Canada
2Multiorgan Transplant Unit, King Fahad Specialist Hospital, Dammam, Saudi Arabia
3Division of Gastroenterology, William Osler Health Centre, Brampton, Canada
4Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
5Division of Gastroenterology, University of British Columbia, Vancouver, British Columbia, Canada

Received 29 April 2015; Accepted 1 June 2015

Copyright © 2015 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

BACKGROUND: Transient elastography (TE) is a safe and effective technology to noninvasively assess hepatic fibrosis in patients with numerous liver conditions. TE is not readily available to all Canadians, and data regarding how this technology is incorporated into clinical practice are lacking.

OBJECTIVE: To describe TE practices in Canada, and to identify strategies to optimize access and usage.

METHODS: All Canadian centres with TE devices were invited to complete a survey after obtaining purchasing data from the national distributor of the device. Descriptive statistics were generated.

RESULTS: Forty-two devices were available in Canada as of January 2015. Seventy-one percent are used in academic settings, 74% are hospital based and 26% are in private clinics. The test is performed by trained nurses in 48% of centres, physicians in 19%, technicians in 9.5% and by any member of the health care team in 19%. Nineteen percent of centres provide satellite clinics to perform the test. While the majority of the centres perform the test at no additional cost to patients, 29% charge a variable fee.

CONCLUSION: In Canada, most TE devices are used in academic and/or hospital-based settings, thus limiting access to this technology to many patients. A sizeable minority of centres mandate patients pay variable out-of-pocket fees. Satellite clinics offered by some centres could increase access, but are not widespread. The lack of uniformity with TE practices in Canada suggests that a national policy is needed.