Evidence map›Paper›PMID 33974935›Full record

ArticleGastroenterology2021

The Optimal Age to Stop Endoscopic Surveillance of Patients With Barrett's Esophagus Based on Sex and Comorbidity: A Comparative Cost-Effectiveness Analysis.

Amir-Houshang Omidvari, William D Hazelton, Brianna N Lauren, Steffie K Naber, Minyi Lee, Ayman Ali, Claudia Seguin, Chun Yin Kong, Ellen Richmond, Joel H Rubenstein and 4 more

Open access · bronzeAbstract readComparative Study
In one paragraph

Article in Gastroenterology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
3.6field-weighted citation impact, top 7% of its field
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 24 citations in OpenAlex.

  1. Article
  2. Gastro-Esophageal Disorders of the Geriatric Population.The American journal of gastroenterology · 2025
    Article
  3. Article
  4. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 8 institutions in 2 countries.

Amir-Houshang OmidvariDepartment of Public Health, Erasmus MC University Medical Center Rotterdam, the Netherlands. Electronic address: a.omidvari@erasmusmc.nl.
William D HazeltonProgram in Computational Biology, Fred Hutchinson Cancer Research Center, Seattle, Washington.
Brianna N LaurenDepartment of Medicine, Columbia University, New York, New York.
Steffie K NaberDepartment of Public Health, Erasmus MC University Medical Center Rotterdam, the Netherlands.
Minyi LeeInstitute for Technology Assessment, Massachusetts General Hospital, Boston, Massachusetts.
Ayman AliTulane University School of Medicine, New Orleans, Louisiana.
Claudia SeguinInstitute for Technology Assessment, Massachusetts General Hospital, Boston, Massachusetts.
Chun Yin KongInstitute for Technology Assessment, Massachusetts General Hospital, Boston, Massachusetts.
Ellen RichmondDivision of Cancer Prevention, National Cancer Institute, Rockville, Maryland.
Joel H RubensteinBarrett's Esophagus Program, Division of Gastroenterology, University of Michigan, Ann Arbor, Michigan; Veterans Affairs Center for Clinical Management Research, Ann Arbor, Michigan.
Georg E LuebeckProgram in Computational Biology, Fred Hutchinson Cancer Research Center, Seattle, Washington.
John M InadomiDepartment of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah.
Chin HurDepartment of Medicine, Columbia University, New York, New York.
Iris Lansdorp-VogelaarDepartment of Public Health, Erasmus MC University Medical Center Rotterdam, the Netherlands.
Erasmus MC · NLMassachusetts General Hospital · USColumbia University · USFred Hutch Cancer Center · USNational Cancer Institute · USTulane University · USUniversity of Michigan · USUniversity of Utah · US

Funding

Controlling Esophageal Cancer: A Collaborative Modeling ApproachU01CA199336 · NCI · MASSACHUSETTS GENERAL HOSPITAL · PI HUR, CHIN, INADOMI, JOHN MATTHEW · 2015 to 2019
$5.9M
Controlling Esophageal Cancer in the US.: A Colloraborative Modeling ProjectU01CA152926 · NCI · MASSACHUSETTS GENERAL HOSPITAL · PI HUR, CHIN, INADOMI, JOHN MATTHEW · 2010 to 2014
$3.9M
A Personalized Approach to Targeted Esophageal Cancer ScreeningR01CA247790 · NCI · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI HUR, CHIN · 2020 to 2024
$2.5M
High-Performance Compute Cluster for Comprehensive Cancer and Infectious Diseases ResearchS10OD028685 · OD · FRED HUTCHINSON CANCER RESEARCH CENTER · PI BRADLEY, PHILIP · 2020 to 2020
$2.0M
Improving Gastrointestinal Disease Outcomes in Vulnerable PopulationsK24DK080941 · NIDDK · UNIVERSITY OF WASHINGTON · PI INADOMI, JOHN MATTHEW · 2008 to 2019
$1.8M
NCI NIH HHS R01 CA247790NCI NIH HHS U01 CA152926NCI NIH HHS U01 CA199336NIDDK NIH HHS K24 DK080941NIH HHS S10 OD028685
6 · The paper itself

Abstract

BACKGROUND AND

aimsCurrent guidelines recommend surveillance for patients with nondysplastic Barrett's esophagus (NDBE) but do not include a recommended age for discontinuing surveillance. This study aimed to determine the optimal age for last surveillance of NDBE patients stratified by sex and level of comorbidity.

methodsWe used 3 independently developed models to simulate patients diagnosed with NDBE, varying in age, sex, and comorbidity level (no, mild, moderate, and severe). All patients had received regular surveillance until their current age. We calculated incremental costs and quality-adjusted life-years (QALYs) gained from 1 additional endoscopic surveillance at the current age versus not performing surveillance at that age. We determined the optimal age to end surveillance as the age at which incremental cost-effectiveness ratio of 1 more surveillance was just less than the willingness-to-pay threshold of $100,000/QALY.

resultsThe benefit of having 1 more surveillance endoscopy strongly depended on age, sex, and comorbidity. For men with NDBE and severe comorbidity, 1 additional surveillance at age 80 years provided 4 more QALYs per 1000 patients with BE at an additional cost of $1.2 million, whereas for women with severe comorbidity the benefit at that age was 7 QALYs at a cost of $1.3 million. For men with no, mild, moderate, and severe comorbidity, the optimal ages of last surveillance were 81, 80, 77, and 73 years, respectively. For women, these ages were younger: 75, 73, 73, and 69 years, respectively.

conclusionsOur comparative modeling analysis illustrates the importance of considering comorbidity status and sex when deciding on the age to discontinue surveillance in patients with NDBE.

Indexed as

Decision Support TechniquesHealth Care CostsAdenocarcinomaAgedAged, 80 and overAge FactorsBarrett EsophagusClinical Decision-MakingComorbidityComputer SimulationCost-Benefit AnalysisEarly Detection of CancerEsophageal NeoplasmsEsophagoscopyFemaleHumansCEAEACEsophageal CancerStop Age

Identifiers

PMID33974935
PMCPMC8495224
OpenAlexW3163910410

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

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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.