Clinical Perspectives in Pancreatology: Compliance with Acute Pancreatitis Guidelines in Germany

a mean response rate of only 54% [10] . In our survey, 182 of the 190 gastroenterologists replied and had completed the questionnaire, resulting in a response rate of 96% and excluding any non-respondent bias. The knowledge and awareness of the content of international consensus guideline recommendations for the diagnosis and/or treatment of acute pancreatitis varied. Not surprisingly, almost all German gastroenterologists were aware of the guideline recommendations of the German (DGVS) Consensus Conference [5] . About 50% knew of the content of the guidelines provided by the Atlanta Symposium [1] , the British Society of Gastroenterology [2] , and the World Congress of Gastroenterology [6] , whereas more than two thirds were unaware of other international guidelines ( table 2 ). Table 1 illustrates to what extent 10 key recommendations regarding acute pancreatitis were complied with in Germany. To determine the severity of the disease, German gastroenterologists tended to prefer imaging procedures, such as ultrasound and computed tomography, rather than multifactor-scoring systems. Since the validity of ultrasound examinations has never been demonstrated for assessing the severity of acute pancreatitis, this preference may be driven by compliance with insurance reimbursement plans or clinical training curWithin the last decade, no fewer than eight guidelines for the management of acute pancreatitis have been published [1– 8] . When individual guidelines are compared, marked similarities emerge and signifi cant differences are uncommon ( table 1 ) [9] . It is, however, unknown whether these guidelines are accepted by physicians and used in clinical practice. We have determined whether and to what extent German gastroenterologists comply with published guidelines for acute pancreatitis. A questionnaire concerning the ten main issues of the eight guidelines ( table 1 ) was sent to the 190 members of the Ar beitsgemeinschaft Leitender Gastroenterologischer Krankenhausarzte (ALGK) . Members of this professional association are all boardcertifi ed gastroenterologists and are either in charge of a gastroenterology division, are within a department of medicine or heads of a department of gastroenterology and hepatology. At their respective institutions, they have ultimate responsibility for the diagnosis and treatment of patients with acute pancreatitis. The answers to the questionnaire were evaluated against the published guidelines of the eight consensus conferences. Mailed surveys are a useful tool for examining attitudes and behavior in healthcare settings, but in order to be successful and avoid bias, they require a high response rate. Published surveys of physicians show Published online: August 16, 2005