Evidence map›Paper›PMID 24219822›Full record

Trial reportGastrointestinal endoscopy2014

In vivo endomicroscopy improves detection of Barrett's esophagus-related neoplasia: a multicenter international randomized controlled trial (with video).

Marcia Irene Canto, Sharmila Anandasabapathy, William Brugge, Gary W Falk, Kerry B Dunbar, Zhe Zhang, Kevin Woods, Jose Antonio Almario, Ursula Schell, John Goldblum and 4 more

Registry-linked trialAbstract readComparative StudyMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Gastrointestinal endoscopy, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01124214 (In Vivo Endomicroscopy), which is not on this map. Cited by 84 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
84citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

NCT01124214 nacompletednot on this map

In Vivo Endomicroscopy (EM) for Improved Diagnosis of Barrett's Esophagus (BE) and Associated Neoplasia: A Multicenter Randomized Controlled Trial of Diagnostic Yield and Clinical Impact

TypeinterventionalSponsorJohns Hopkins UniversityRan2010 to 2013Enrolled68ConditionsBarrett's Esophagus, Esophageal Intraepithelial NeoplasiaArmsendomicroscopy
3 · Its place in the literature

Who cites it

84 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Guideline
  2. Pooled it
  3. Trial
  4. Trial
  5. Trial
  6. Trial
  7. Advances in the Diagnosis of Barrett's Esophagus.Diagnostics (Basel, Switzerland) · 2026
    Review
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  11. Review
  12. Review
  13. Article
  14. Review
  15. Review
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24 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors.

Marcia Irene CantoDivision of Gastroenterology, Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Sharmila AnandasabapathyMount Sinai Medical Center, New York, New York, USA.
William BruggeHarvard Medical School/Massachusetts General Hospital, Boston, Massachusetts, USA.
Gary W FalkUniversity of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Kerry B DunbarDallas Veterans Affairs Medical Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Zhe ZhangDivision of Biostatistics and Bioinformatics, Department of Oncology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Kevin WoodsEmory University School of Medicine/Emory University Hospital, Atlanta, Georgia, USA.
Jose Antonio AlmarioDivision of Gastroenterology, Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Ursula SchellJohannes Guttenberg University, Mainz, Germany.
John GoldblumDepartment of Anatomic Pathology, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Anirban MaitraDepartment of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Elizabeth MontgomeryDepartment of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Ralf KiesslichJohannes Guttenberg University, Mainz, Germany.
Confocal Endomicroscopy for Barrett's Esophagus or Confocal Endomicroscopy for Barrett's Esophagus (CEBE) Trial Group

Funding

RESEARCH TRAINING IN DIGESTIVE DISEASES AND NUTRITIONT32DK007191 · NIDDK · MASSACHUSETTS GENERAL HOSPITAL · PI RAYMOND T CHUNG · 1986 to 2026
$14.6M
NIDDK NIH HHS T32 DK007191
6 · The paper itself

Abstract

backgroundConfocal laser endomicroscopy (CLE) enables in vivo microscopic imaging of the GI tract mucosa. However, there are limited data on endoscope-based CLE (eCLE) for imaging Barrett's esophagus (BE).

objectiveTo compare high-definition white-light endoscopy (HDWLE) alone with random biopsy (RB) and HDWLE + eCLE and targeted biopsy (TB) for diagnosis of BE neoplasia.

designMulticenter, randomized, controlled trial.

settingAcademic medical centers. PATIENTS: Adult patients with BE undergoing routine surveillance or referred for early neoplasia.

interventionPatients were randomized to HDWLE + RB (group 1) or HDWLE + eCLE + TB (group 2). Real-time diagnoses and management plans were recorded after HDWLE in both groups and after eCLE in group 2. Blinded expert pathology diagnosis was the reference standard. MAIN OUTCOME MEASUREMENTS: Diagnostic yield, performance characteristics, clinical impact.

resultsA total of 192 patients with BE were studied. HDWLE + eCLE + TB led to a lower number of mucosal biopsies and higher diagnostic yield for neoplasia (34% vs 7%; P < .0001), compared with HDWLE + RB but with comparable accuracy. HDWLE + eCLE + TB tripled the diagnostic yield for neoplasia (22% vs 6%; P = .002) and would have obviated the need for any biopsy in 65% of patients. The addition of eCLE to HDWLE increased the sensitivity for neoplasia detection to 96% from 40% (P < .0001) without significant reduction in specificity. In vivo CLE changed the treatment plan in 36% of patients. LIMITATIONS: Tertiary-care referral centers and expert endoscopists limit generalizability.

conclusionReal-time eCLE and TB after HDWLE can improve the diagnostic yield and accuracy for neoplasia and significantly impact in vivo decision making by altering the diagnosis and guiding therapy. ( CLINICAL TRIAL REGISTRATION NUMBER: NCT01124214.).

Indexed as

Microscopy, ConfocalAdultAgedAged, 80 and overBarrett EsophagusBiopsyEsophageal NeoplasmsEsophagoscopyEsophagusFemaleFollow-Up StudiesHumansImage EnhancementMaleMiddle AgedProspective StudiesBarrett's esophagusBECLEconfocal laser endomicroscopyCPTCurrent Procedural TerminologyECAeCLEendoscope-based CLEesophageal adenocarcinomaHDWLEHGDhigh-definition white-light endoscopyhigh-grade dysplasianarrow-band imagingNBIpCLEprobe-based CLErandom biopsyRBtargeted biopsyTBwhite-light endoscopyWLE

Identifiers

PMID24219822
PMCPMC4668117

What OpenQuestion holds

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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.