ArticleGastroenterology2012
The cost effectiveness of radiofrequency ablation for Barrett's esophagus.
Article in Gastroenterology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 60 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
60 citing papers in PubMed, 2 syntheses or guidelines pooled it, 144 citations in OpenAlex.
- AGA Clinical Practice Guideline on Endoscopic Eradication Therapy of Barrett's Esophagus and Related Neoplasia.Gastroenterology · 2024Guideline
- ACG Clinical Guideline: Diagnosis and Management of Barrett's Esophagus.The American journal of gastroenterology · 2016Guideline
- Comparison of Invasive Interventions for Halting the Progression of Barrett's Esophagus.Cureus · 2026Review
- Barrett's oesophagus surveillance in a centralised system: implications for progression risk and management.Journal of thoracic disease · 2026Article
- 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
- Review
- 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 of Esophageal Adenocarcinoma, Mortality, and Esophagectomy in Barrett's Esophagus Patients Undergoing Endoscopic Eradication Therapy.Digestive diseases and sciences · 2023Article
- Comparative cost-effectiveness of three post-radiofrequency ablation surveillance intervals for Barrett's esophagus.Endoscopy international open · 2022Article
- Prognostic, Diagnostic and Predictive Biomarkers in the Barrett's Oesophagus-Adenocarcinoma Disease Sequence.Cancers · 2022Review
- Endoscopic Screening Program for Control of Esophageal Adenocarcinoma in Varied Populations: A Comparative Cost-Effectiveness Analysis.Gastroenterology · 2022Article
- Management of nondysplastic Barrett's esophagus: When to survey? When to ablate?Therapeutic advances in chronic disease · 2022Review
- Comparative Cost Effectiveness of Reflux-Based and Reflux-Independent Strategies for Barrett's Esophagus Screening.The American journal of gastroenterology · 2021Article
- The Optimal Age to Stop Endoscopic Surveillance of Patients With Barrett's Esophagus Based on Sex and Comorbidity: A Comparative Cost-Effectiveness Analysis.Gastroenterology · 2021Article
- Global burden and epidemiology of Barrett oesophagus and oesophageal cancer.Nature reviews. Gastroenterology & hepatology · 2021Review
- Best Practices in Surveillance for Barrett's Esophagus.Gastrointestinal endoscopy clinics of North America · 2021Review
- Endoscopic Eradication Therapy for Barrett's Neoplasia: Where Do We Stand a Decade Later?Current gastroenterology reports · 2020Review
- 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
- Novel biomarkers for risk stratification of Barrett's oesophagus associated neoplastic progression-epithelial HMGB1 expression and stromal lymphocytic phenotype.British journal of cancer · 2020Article
Corrections and comments
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Authors and funding
7 authors at 5 institutions in 1 country.
Funding
Abstract
BACKGROUND &
aimsRadiofrequency ablation (RFA) reduces the risk of esophageal adenocarcinoma (EAC) in patients with Barrett's esophagus (BE) with high-grade dysplasia (HGD), but its effects in patients without dysplasia are debatable. We analyzed the effectiveness and cost effectiveness of RFA for the management of BE.
methodsWe constructed a decision analytic Markov model. We conducted separate analyses of hypothetical cohorts of patients with BE with dysplasia (HGD or low-grade [LGD]) and without dysplasia. In the analysis of the group with HGD, we compared results of initial RFA with endoscopic surveillance with surgery when cancer was detected. In analyzing the group with LGD or no dysplasia, we compared 3 strategies: endoscopic surveillance with surgery when cancer was detected (S1), endoscopic surveillance with RFA when HGD was detected (S2), and initial RFA followed by endoscopic surveillance (S3).
resultsAmong patients with HGD, initial RFA was more effective and less costly than endoscopic surveillance. Among patients with LGD, when S3 was compared with S2, the incremental cost-effectiveness ratio was $18,231/quality-adjusted life-year, assuming an annual rate of progression rate from LGD to EAC of 0.5%/year. For patients without dysplasia, S2 was more effective and less costly than S1. In a comparison of S3 with S2, the incremental cost-effectiveness ratios were $205,500, $124,796, and $118,338/quality-adjusted life-year using annual rates of progression of no dysplasia to EAC of 0.12%, 0.33%, or 0.5% per year, respectively.
conclusionsBy using updated data, initial RFA might not be cost effective for patients with BE without dysplasia, within the range of plausible rates of progression of BE to EAC, and be prohibitively expensive, from a policy perspective. RFA might be cost effective for confirmed and stable LGD. Initial RFA is more effective and less costly than endoscopic surveillance in HGD.
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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.