Evidence map›Paper›PMID 35295750›Full record

ArticleFrontline gastroenterology2022

Risk stratifying gastric ulcers: development and validation of a scoring system.

William M Brindle, Rebecca K Grant, Marianne Smith, Meghan Suddaby, Angus Wallace, Sarah-Louise Gillespie, Nicholas I Church, Colin L Noble, Ian D Penman, John N Plevris and 6 more

Open access · greenAbstract read
In one paragraph

Article in Frontline gastroenterology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.8field-weighted citation impact, top 28% 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

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 3 institutions in 1 country.

William M BrindleThe Centre for Liver and Digestive Disorders, Royal Infirmary of Edinburgh, Edinburgh, UK.ORCID 0000-0002-8972-0332
Rebecca K GrantThe Centre for Liver and Digestive Disorders, Royal Infirmary of Edinburgh, Edinburgh, UK.ORCID 0000-0002-9440-1192
Marianne SmithThe Centre for Liver and Digestive Disorders, Royal Infirmary of Edinburgh, Edinburgh, UK.
Meghan SuddabyThe Centre for Liver and Digestive Disorders, Royal Infirmary of Edinburgh, Edinburgh, UK.
Angus WallaceThe Centre for Liver and Digestive Disorders, Royal Infirmary of Edinburgh, Edinburgh, UK.
Sarah-Louise GillespieThe Centre for Liver and Digestive Disorders, Royal Infirmary of Edinburgh, Edinburgh, UK.
Nicholas I ChurchThe Centre for Liver and Digestive Disorders, Royal Infirmary of Edinburgh, Edinburgh, UK.
Colin L NobleThe Edinburgh IBD Unit, Western General Hospital, Edinburgh, UK.
Ian D PenmanThe Centre for Liver and Digestive Disorders, Royal Infirmary of Edinburgh, Edinburgh, UK.ORCID 0000-0003-0785-6744
John N PlevrisThe Centre for Liver and Digestive Disorders, Royal Infirmary of Edinburgh, Edinburgh, UK.
Alexander R RobertsonThe Edinburgh IBD Unit, Western General Hospital, Edinburgh, UK.
Eleanor F WatsonThe Edinburgh IBD Unit, Western General Hospital, Edinburgh, UK.
Christian P SelingerLeeds Gastroenterology Institute, Leeds Teaching Hospitals NHS Trust, Leeds, UK.ORCID 0000-0003-2022-5859
Rahul KallaThe Centre for Liver and Digestive Disorders, Royal Infirmary of Edinburgh, Edinburgh, UK.ORCID 0000-0002-3276-6751
Gail S M MastertonThe Centre for Liver and Digestive Disorders, Royal Infirmary of Edinburgh, Edinburgh, UK.
EGAR (Edinburgh GI Audit and Research) Collaborative
Edinburgh Royal Infirmary · GBWestern General Hospital · GBLeeds Teaching Hospitals NHS Trust · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: Debate is ongoing regarding the need for universal endoscopic follow-up to ensure gastric ulcer healing. We aimed to assess the value of follow-up oesophago-gastro-duodenoscopies (OGDs) for gastric ulcer healing and stratify patients according to risk of malignancy by developing a risk score. Design/method: All patients in National Health Service (NHS) Lothian with an index OGD and a diagnosis of gastric ulcer between 1 January 2014 and 31 December 2018 were identified. Data were analysed with logistic regression to identify factors significantly associated with a diagnosis of cancer; a risk score was derived and externally validated. Results: 778 patients were identified and 60.3% (469/778) of patients had a follow-up OGD. 8.6% (66/778) of patients were diagnosed with cancer. No cases of cancer were found on follow-up OGD of a benign appearing ulcer with negative biopsies. Macroscopic suspicion of malignancy was present at index OGD in 100% (3/3) of those diagnosed with cancer on subsequent OGDs. Older age (p=0.014), increased ulcer size (p<0.001) and non-antral location (p=0.030) were significantly associated with malignancy. A risk score (area under the curve (AUC) 0.868, p<0.001, minimum score=0, maximum score=6) was derived from these variables. 78.0% of patients with malignant ulcers scored ≥3, only 15.8% with benign ulcers scored ≥3 (negative predictive value (NPV) 97.4%). External validation yielded an AUC of 0.862 (p<0.001) and NPV of 98.6%; 84.0% of those with malignant ulcers scored ≥3. Conclusion: Ulcers with a combination of macroscopically benign appearances, at least six negative biopsies and a low risk score do not necessarily need endoscopic follow-up.

Indexed as

gastric and duodenal ulcersgastrointesinal endoscopygastrointestinal cancer

Identifiers

PMID35295750
PMCPMC8862450
OpenAlexW3135390592

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.