ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2020
Optimizing Management of Patients With Barrett's Esophagus and Low-Grade or No Dysplasia Based on Comparative Modeling.
Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 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
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 21 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
- Barrett's oesophagus surveillance in a centralised system: implications for progression risk and management.Journal of thoracic disease · 2026Article
- Evaluating Cost-Effectiveness of 85 Endoscopic Surveillance Strategies of Nondysplastic Barrett's Esophagus.Journal of gastroenterology and hepatology · 2026Article
- Cost-Effectiveness of Endoscopic Stricturotomy Versus Resection Surgery for Crohn's Disease Strictures.Healthcare (Basel, Switzerland) · 2025Article
- Endoscopic Balloon Dilation Is Cost-Effective for Crohn's Disease Strictures.Digestive diseases and sciences · 2022Article
- Comparative cost-effectiveness of three post-radiofrequency ablation surveillance intervals for Barrett's esophagus.Endoscopy international open · 2022Article
- Endoscopic Screening Program for Control of Esophageal Adenocarcinoma in Varied Populations: A Comparative Cost-Effectiveness Analysis.Gastroenterology · 2022Article
- Endoscopic Management of Barrett's Esophagus.Digestive diseases and sciences · 2022Review
- Management of nondysplastic Barrett's esophagus: When to survey? When to ablate?Therapeutic advances in chronic disease · 2022Review
- The natural history of low-grade dysplasia in Barrett's esophagus and risk factors for progression.JGH open : an open access journal of gastroenterology and hepatology · 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
- 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
- Endoscopic eradication therapy for Barrett's oesophagus: state of the art.Current opinion in gastroenterology · 2020Review
Corrections and comments
- Commented on by
Authors and funding
15 authors at 8 institutions in 2 countries.
Funding
Abstract
BACKGROUND &
aimsEndoscopic treatment is recommended for patients with Barrett's esophagus (BE) with high-grade dysplasia, yet clinical management recommendations are inconsistent for patients with BE without dysplasia (NDBE) or with low-grade dysplasia (LGD). We used a comparative modeling analysis to identify optimal management strategies for these patients.
methodsWe used 3 independent population-based models to simulate cohorts of 60-year-old individuals with BE in the United States. We followed up each cohort until death without surveillance and treatment (natural disease progression), compared with 78 different strategies of management for patients with NDBE or LGD. We determined the optimal strategy using cost-effectiveness analyses, at a willingness-to-pay threshold of $100,000 per quality-adjusted life-year (QALY).
resultsIn the 3 models, the average cumulative incidence of esophageal adenocarcinoma was 111 cases, with costs totaling $5.7 million per 1000 men with BE. Surveillance and treatment of men with BE prevented 23% to 75% of cases of esophageal adenocarcinoma, but increased costs to $6.2 to $17.3 million per 1000 men with BE. The optimal strategy was surveillance every 3 years for men with NDBE and treatment of LGD after confirmation by repeat endoscopy (incremental cost-effectiveness ratio, $53,044/QALY). The average results for women were consistent with the results for men for LGD management, but the optimal surveillance interval for women with NDBE was 5 years (incremental cost-effectiveness ratio, $36,045/QALY).
conclusionsBased on analyses from 3 population-based models, the optimal management strategy for patient with BE and LGD is endoscopic eradication, but only after LGD is confirmed by a repeat endoscopy. The optimal strategy for patients with NDBE is endoscopic surveillance, using a 3-year interval for men and a 5-year interval for women.
Indexed as
Identifiers
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.