Barrett's esophagus is frequently overdiagnosed in clinical practice: results of the Barrett's Esophagus Endoscopic Revision (BEER) study.
Background: The published prevalence of Barrett's esophagus (BE) varies from 0.9% to 25%, in part because of differences in the endoscopic interpretation of the disease. Objective: We studied the accuracy of diagnosis in 130 patients previously labeled as having BE. Our aim was to determine the inte...
| Publicado en: | Gastrointestinal Endoscopy Vol. 79; no. 4; pp. 565 - 574 |
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| Autores principales: | , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Elsevier B.V.
Apr2014
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104048791&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104048791 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00165107 4A9 jtl: Gastrointestinal Endoscopy issn: 00165107 maglogo: N pubinfo: dt: Apr2014 vid: 79 iid: 4 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 104048791 94963000 10.1016/j.gie.2013.09.024 NLM24262638 104048791 ppf: 565 ppct: 9 formats: tig: atl: Barrett's esophagus is frequently overdiagnosed in clinical practice: results of the Barrett's Esophagus Endoscopic Revision (BEER) study. aug: au: Ganz, Robert A. Allen, John I. Leon, Sam Batts, Kenneth P. affil: Minnesota Gastroenterology PA, Plymouth, Minnesota, USA; University of Minnesota, Minneapolis, Minnesota, USA sug: subj: Barrett Esophagus Diagnosis Diagnostic Errors Human Academic Medical Centers Minnesota Videorecording Utilization Confidence Intervals Utilization Biopsy Utilization Retrospective Design Utilization Medical Records Utilization Male Female Descriptive Statistics Utilization Age Factors Sex Factors Male Female ab: Background: The published prevalence of Barrett's esophagus (BE) varies from 0.9% to 25%, in part because of differences in the endoscopic interpretation of the disease. Objective: We studied the accuracy of diagnosis in 130 patients previously labeled as having BE. Our aim was to determine the interobserver consistency of endoscopic findings and assess the percentage of patients with confirmed BE versus those with a revised diagnosis. Design/Setting/Patients: Patients previously diagnosed with BE of any length and due for surveillance endoscopy were eligible for study. Interventions: After intensive consensus anatomic and endoscopic review, study patients underwent endoscopy and biopsy by 1 of 3 endoscopists. BE was defined as any length of columnar-lined esophagus with goblet cells. Main Outcome Measurements: Patients were photographed/videotaped for review by the other 2 endoscopists, and BE was either confirmed or revised. Results: Eighty-eight patients (67.7%) had confirmed BE, and 42 (32.3%) had their diagnosis revised to no BE (95% confidence interval, 24.4%-41.1%) because there was no visible columnar-lined esophagus proximal to the gastric folds or no goblet cells were found on biopsy. BE length, site of previous endoscopy, age, sex, and hiatal hernia size were predictors of revision. All 3 endoscopists agreed on all confirmed BE cases and 38 of 42 of those revised. Limitations: Retrospective analysis, possible sampling error. Conclusions: BE is overdiagnosed in clinical practice with important implications for patient care including increased costs, reduced insurability, and psychological stress. The true BE cancer risk may also be underestimated. This study suggests the need for a better definition of the gastroesophageal junction, stricter accountability for BE diagnosis, and improved endoscopic education. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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