ArticleThe American journal of gastroenterology2021
Comparative Cost Effectiveness of Reflux-Based and Reflux-Independent Strategies for Barrett's Esophagus Screening.
Article in The American journal of gastroenterology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 3 of them syntheses that pooled it.
What it found
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 3 syntheses or guidelines pooled it, 34 citations in OpenAlex.
- Cost effectiveness analysis of Barrett's esophagus screening: A systematic review.Best practice & research. Clinical gastroenterology · 2025Pooled it
- Diagnosis and treatment of patients with gastroesophageal reflux disease - a systematic review of cost-effectiveness and economic burden.BMC health services research · 2024Pooled it
- Prevalence of Barrett's Esophagus and Esophageal Adenocarcinoma With and Without Gastroesophageal Reflux: A Systematic Review and Meta-analysis.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2024Pooled it
- A Practical Guide to Incorporating Novel Barrett's Screening/Surveillance Tools into Clinical Practice.Current gastroenterology reports · 2026Review
- Discovery and Validation of Molecular Biomarkers for Differentiation of Nondysplastic Barrett's Esophagus from High-grade Dysplasia and Esophageal Adenocarcinoma.Cancer prevention research (Philadelphia, Pa.) · 2026Article
- Nonendoscopic Screening for Barrett's Esophagus: Current Methods, Evidence, and Future Directions.Gastro hep advances · 2026Review
- Endoscopic Screening of Barrett's Esophagus.Gastrointestinal endoscopy clinics of North America · 2026Review
- Liquid biopsy to identify Barrett's oesophagus, dysplasia and oesophageal adenocarcinoma: theGut · 2025Article
- Cost-effective identification of Barrett's esophagus in the community: A first step towards screening.Journal of gastroenterology and hepatology · 2024Article
- Barrett's Esophagus Risk Factors in Patients Without Gastroesophageal Reflux: A Large Population-Based Study.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2024Article
- Prospect and Challenges of Volatile Organic Compound Breath Testing in Non-Cancer Gastrointestinal Disorders.Biomedicines · 2024Review
- Trends in oesophageal cancer mortality in Montenegro, 1990-2018.European journal of public health · 2024Article
- Improving esophageal cancer screening across the globe: Translating knowledge into action.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2024Review
- Algorithm Training and Testing for a Nonendoscopic Barrett's Esophagus Detection Test in Prospective Multicenter Cohorts.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2024Article
- Advances in Screening for Barrett Esophagus and Esophageal Adenocarcinoma.Mayo Clinic proceedings · 2024Review
- Prevalence and Predictors of Barrett's Esophagus After Negative Initial Endoscopy: Analysis From Two National Databases.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2024Article
- Utilization trends for endoscopic ablation therapy and esophagectomy in Barrett's esophagus from 2005 to 2019.Scientific reports · 2022Observational
- Endoscopic Screening Program for Control of Esophageal Adenocarcinoma in Varied Populations: A Comparative Cost-Effectiveness Analysis.Gastroenterology · 2022Article
- Unsedated Transnasal Endoscopy: A Safe, Well-Tolerated and Accurate Alternative to Standard Diagnostic Peroral Endoscopy.Digestive diseases and sciences · 2022Review
Corrections and comments
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Authors and funding
10 authors at 6 institutions in 3 countries.
Funding
Abstract
introductionMinimally invasive tests for Barrett's esophagus (BE) detection have raised the prospect of broader nonreflux-based testing. Cost-effectiveness studies have largely studied men aged 50 years with chronic gastroesophageal reflux disease (GERD) symptoms. We evaluated the comparative cost effectiveness of BE screening tests in GERD-based and GERD-independent testing scenarios.
methodsMarkov modeling was performed in 3 scenarios in 50 years old individuals: (i) White men with chronic GERD (GERD-based); (ii) GERD-independent (all races, men and women), BE prevalence 1.6%; and (iii) GERD-independent, BE prevalence 5%. The simulation compared multiple screening strategies with no screening: sedated endoscopy (sEGD), transnasal endoscopy, swallowable esophageal cell collection devices with biomarkers, and exhaled volatile organic compounds. A hypothetical cohort of 500,000 individuals followed for 40 years using a willingness to pay threshold of $100,000 per quality-adjusted life year (QALY) was simulated. Incremental cost-effectiveness ratios (ICERs) comparing each strategy with no screening and comparing screening strategies with each other were calculated.
resultsIn both GERD-independent scenarios, most non-sEGD BE screening tests were cost effective. Swallowable esophageal cell collection devices with biomarkers were cost effective (<$35,000/QALY) and were the optimal screening tests in all scenarios. Exhaled volatile organic compounds had the highest ICERs in all scenarios. ICERs were low (<$25,000/QALY) for all tests in the GERD-based scenario, and all non-sEGD tests dominated no screening. ICERs were sensitive to BE prevalence and test costs. DISCUSSION: Minimally invasive nonendoscopic tests may make GERD-independent BE screening cost effective. Participation rates for these strategies need to be studied.
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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.