Evidence map›Paper›PMID 41492063›Full record

ArticleBMC gastroenterology2026

Validation of the BEST-J score and identification of bile reflux as a risk factor for delayed bleeding after gastric endoscopic submucosal dissection.

Linfeng Zou, Yingyun Yang, Jihua Shi, Wanying Liao, Siyang Fu, Qiang Wang, Aiming Yang

Abstract readValidation StudyMulticenter Study
In one paragraph

Article in BMC gastroenterology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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.

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

1 citing paper in PubMed.

  1. 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

7 authors.

Linfeng Zou *Department of Gastroenterology, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Yingyun Yang *Department of Gastroenterology, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Jihua ShiDepartment of Gastroenterology, Beijing Hospital, National Center of Gerontology, Beijing, China.
Wanying LiaoDepartment of Internal Medicine, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Siyang FuEight-year Clinical Medicine Program, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
Qiang WangDepartment of Gastroenterology, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China. pekingunion@aliyun.com.
Aiming YangDepartment of Gastroenterology, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China. yangam2020@126.com.

Funding

Beijing Municipal Health Commission Research Ward Excellence Clinical Research Program BRWEP2024W034010107National High-Level Hospital Clinical Research Funding 2022-PUMCH-C-063State Key Laboratory of Pathogenesis, Prevention, Treatment of Central Asian High Incidence Diseases Funding SKL-HIDCA-2024-GB3
6 · The paper itself

Abstract

backgroundGastric cancer (GC) is a leading cause of cancer-related morbidity and mortality globally. Endoscopic submucosal dissection (ESD) has improved survival rates for early gastric cancer (EGC), but complications such as delayed bleeding remain a concern. This multicenter retrospective study aimed to validate the BEST-J prediction model for post-ESD bleeding in two Beijing hospitals and identify additional risk factors influencing this complication.

methodsWe analyzed data from 688 patients who underwent ESD for EGC across two institutions. Patient demographics, procedural details, and comorbidities were collected. The BEST-J score was calculated for each patient, and Firth’s penalized logistic regression was performed to identify independent risk factors for delayed bleeding.

resultsOur findings revealed that the BEST-J score had limited discriminative power in predicting post-ESD bleeding (AUC = 0.583). However, two independent risk factors—previous cerebral infarction (p = 0.012) and bile reflux (p = 0.012)—were significantly associated with delayed bleeding.

conclusionThis study underscores the necessity for ongoing validation of predictive models such as BEST-J, particularly across different populations. The identification of cerebral infarction and bile reflux as significant predictors highlights the need to integrate additional factors into risk assessments.

Indexed as

Bile RefluxEndoscopic Mucosal ResectionGastrointestinal HemorrhagePostoperative HemorrhageStomach NeoplasmsAgedFemaleHumansLogistic ModelsMaleMiddle AgedRetrospective StudiesRisk AssessmentRisk FactorsBile refluxDelayed bleedingEndoscopic submucosal dissectionPrediction modelRisk factor

Identifiers

PMID41492063
PMCPMC12870265

What OpenQuestion holds

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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.