ReviewGastroenterology2009
A cost-utility analysis of ablative therapy for Barrett's esophagus.
Review in Gastroenterology, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 67 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
67 citing papers in PubMed, 4 syntheses or guidelines pooled it, 189 citations in OpenAlex.
- AGA Clinical Practice Guideline on Endoscopic Eradication Therapy of Barrett's Esophagus and Related Neoplasia.Gastroenterology · 2024Guideline
- Improving cost-effectiveness of endoscopic surveillance for Barrett's esophagus by reducing low-value care: a review of economic evaluations.Surgical endoscopy · 2021Pooled it
- Surgery versus radical endotherapies for early cancer and high-grade dysplasia in Barrett's oesophagus.The Cochrane database of systematic reviews · 2020Pooled it
- Guidelines for surgical treatment of gastroesophageal reflux disease.Surgical endoscopy · 2010Guideline
- Feasibility, safety, acceptability, and yield of office-based, screening transnasal esophagoscopy (with video).Gastrointestinal endoscopy · 2012Trial
- Durability of radiofrequency ablation in Barrett's esophagus with dysplasia.Gastroenterology · 2011Trial
- Impact of a diagnosis of 'low-grade dysplasia' in patients with Barrett's esophagus.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2026Article
- Evaluating Cost-Effectiveness of 85 Endoscopic Surveillance Strategies of Nondysplastic Barrett's Esophagus.Journal of gastroenterology and hepatology · 2026Article
- Computing lifetime incidence of esophageal adenocarcinoma and age-specific prevalence of Barrett's esophagus.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2025Article
- Factors influencing the cost-effectiveness of radiofrequency ablation for Barrett's esophagus with low-grade dysplasia in Australia.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2025Article
- Incidence rates of Barrett's esophagus and esophageal adenocarcinoma: a systematic review and meta-analysis.iGIE : innovation, investigation and insights · 2024Article
- A cost-effectiveness modeling study of treatment interventions for stage I to III esophageal squamous cell carcinoma.Cost effectiveness and resource allocation : C/E · 2022Article
- Management of nondysplastic Barrett's esophagus: When to survey? When to ablate?Therapeutic advances in chronic disease · 2022Review
- Estimated Cost-effectiveness of Endoscopic Screening for Upper Gastrointestinal Tract Cancer in High-Risk Areas in China.JAMA network open · 2021Article
- Economic evaluation of Cytosponge®-trefoil factor 3 for Barrett esophagus: A cost-utility analysis of randomised controlled trial data.EClinicalMedicine · 2021Article
- Massively Parallel Sequencing of Esophageal Brushings Enables an Aneuploidy-Based Classification of Patients With Barrett's Esophagus.Gastroenterology · 2021Article
- Optimizing Management of Patients With Barrett's Esophagus and Low-Grade or No Dysplasia Based on Comparative Modeling.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2020Article
- Cryoballoon ablation for treatment of patients with refractory esophageal neoplasia after first line endoscopic eradication therapy.Endoscopy international open · 2020Article
- Screening for Barrett's Esophagus: Balancing Clinical Value and Cost-effectiveness.Journal of neurogastroenterology and motility · 2019Article
- A Cost-Effectiveness Analysis Of An Adenocarcinoma Risk Prediction Multi-Biomarker Assay For Patients With Barrett's Esophagus.ClinicoEconomics and outcomes research : CEOR · 2019Article
7 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
BACKGROUND &
aimsRecommendations for patients with Barrett's esophagus (BE) include endoscopic surveillance with esophagectomy for early-stage cancer, although new technologies to ablate dysplasia and metaplasia are available. This study compares the cost utility of ablation with that of endoscopic surveillance strategies.
methodsA decision analysis model was created to examine a population of patients with BE (mean age 50), with separate analyses for patients with no dysplasia, low-grade dysplasia (LGD), or high-grade dysplasia (HGD). Strategies compared were no endoscopic surveillance; endoscopic surveillance with ablation for incident dysplasia; immediate ablation followed by endoscopic surveillance in all patients or limited to patients in whom metaplasia persisted; and esophagectomy. Ablation modalities modeled included radiofrequency, argon plasma coagulation, multipolar electrocoagulation, and photodynamic therapy.
resultsEndoscopic ablation for patients with HGD could increase life expectancy by 3 quality-adjusted years at an incremental cost of <$6,000 compared with no intervention. Patients with LGD or no dysplasia can also be optimally managed with ablation, but continued surveillance after eradication of metaplasia is expensive. If ablation permanently eradicates >or=28% of LGD or 40% of nondysplastic metaplasia, ablation would be preferred to surveillance.
conclusionsEndoscopic ablation could be the preferred strategy for managing patients with BE with HGD. Ablation might also be preferred in subjects with LGD or no dysplasia, but the cost effectiveness depends on the long-term effectiveness of ablation and whether surveillance endoscopy can be discontinued after successful ablation. As further postablation data become available, the optimal management strategy will be clarified.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.