دورية أكاديمية
أعرض في EDS

Clinical variation in surveillance and management of Barrett's esophagus: A cross-sectional study of gastroenterologists and gastrointestinal surgeons.

التفاصيل البيبلوغرافية
العنوان: Clinical variation in surveillance and management of Barrett's esophagus: A cross-sectional study of gastroenterologists and gastrointestinal surgeons.
المؤلفون: Cruz JD; QURE Healthcare, San Francisco, CA., Paculdo D; QURE Healthcare, San Francisco, CA., Ganesan D; QURE Healthcare, San Francisco, CA., Baker M; QURE Healthcare, San Francisco, CA., Critchley-Thorne RJ; Castle Biosciences, Inc., Pittsburgh, PA., Shaheen NJ; University of North Carolina at Chapel Hill, Chapel Hill, NC., Wani S; University of Colorado Anschutz Medical Center, Aurora, CO., Peabody JW; QURE Healthcare, San Francisco, CA.; University of California, San Francisco, CA.; University of California, Los Angeles, CA.
المصدر: Medicine [Medicine (Baltimore)] 2022 Dec 23; Vol. 101 (51), pp. e32187.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 2985248R Publication Model: Print Cited Medium: Internet ISSN: 1536-5964 (Electronic) Linking ISSN: 00257974 NLM ISO Abbreviation: Medicine (Baltimore) Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Hagerstown, Md : Lippincott Williams & Wilkins
مواضيع طبية MeSH: Barrett Esophagus*/diagnosis , Barrett Esophagus*/therapy , Barrett Esophagus*/pathology , Gastroenterologists* , Precancerous Conditions*/diagnosis , Precancerous Conditions*/therapy , Precancerous Conditions*/pathology , Esophageal Neoplasms*/diagnosis , Surgeons*, Humans ; Cross-Sectional Studies ; Disease Progression ; Hyperplasia
مستخلص: Appropriate surveillance and treatment of Barrett's esophagus (BE) is vital to prevent disease progression and decrease esophageal adenocarcinoma (EAC)-related mortality. We sought to determine the variation in BE care and identify improvement opportunities. 275 physicians (113 general gastroenterologists, 128 interventional gastroenterologists, 34 gastrointestinal surgeons) cared for 3 simulated patients, one each from 3 BE clinical scenarios: non-dysplastic BE (NDBE), BE indefinite for dysplasia (IND), and BE with low grade dysplasia (LGD), and care scores were measured against societal guidelines. Overall quality-of-care scores ranged from 17% to 85% with mean of 47.9% ± 11.8% for NDBE, 50.8% ± 11.7% for IND, and 52.7% ± 12.2% for LGD. Participants appropriately determined risk of progression 20.3% of the time: 14.4% for NDBE cases, 19.9% for LGD cases, and 26.8% for IND cases (P = .001). Treatment and follow-up care scores averaged 12.9% ± 17.5% overall. For the LGD cases, guideline-recommended twice-daily PPI treatment was ordered only 24.7% of the time. Guideline-based follow-up endoscopic surveillance was done in only 27.7% of NDBE cases and 32.7% of IND cases. For the LGD cases, 45.4% ordered endoscopic eradication therapy while 25.1% chose annual endoscopic surveillance. Finally, participants provided counseling on lifestyle modifications in just 20% of cases. Overall care of patients diagnosed with BE varied widely and showed room for improvement. Specific opportunities for improvement were adherence to guideline recommended surveillance intervals, patient counseling, and treatment selection for LGD. Physicians would potentially benefit from additional BE education, endoscopic advances, and better methods for risk stratification.
(Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.)
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تواريخ الأحداث: Date Created: 20230103 Date Completed: 20230105 Latest Revision: 20230111
رمز التحديث: 20230111
مُعرف محوري في PubMed: PMC9794215
DOI: 10.1097/MD.0000000000032187
PMID: 36595793
قاعدة البيانات: MEDLINE
الوصف
تدمد:1536-5964
DOI:10.1097/MD.0000000000032187