Gastro-esophageal reflux disease symptoms and demographic factors as a pre-screening tool for Barrett's esophagus
| Autor: | Andrej Ćorović, Xinxue Liu, Rodney W. Burnham, Angela Wong, Sudarshan R. Kadri, Rebecca C. Fitzgerald, Maria O'Donovan, Laurence Lovat, Pierre Lao-Sirieix |
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| Přispěvatelé: | Fitzgerald, Rebecca [0000-0002-3434-3568], Apollo - University of Cambridge Repository |
| Rok vydání: | 2020 |
| Předmět: |
Male
Health Screening Abdominal pain Cross-sectional study lcsh:Medicine Gastroenterology Risk Factors Medicine and Health Sciences Medicine Mass Screening Public and Occupational Health Prospective Studies lcsh:Science Multidisciplinary medicine.diagnostic_test Cancer Risk Factors Middle Aged humanities FOS: Sociology medicine.anatomical_structure Oncology Research Design Gastroesophageal Reflux Female Anatomy medicine.symptom Research Article Adult medicine.medical_specialty Clinical Research Design General Science & Technology Gastroenterology and Hepatology Research and Analysis Methods Barrett Esophagus Young Adult Esophagus Diagnostic Medicine Internal medicine MD Multidisciplinary Humans Risk factor Intensive care medicine Mass screening Aged Demography business.industry lcsh:R Reflux Biology and Life Sciences Reproducibility of Results medicine.disease digestive system diseases Endoscopy Gastrointestinal Tract Cross-Sectional Studies ROC Curve Barrett's esophagus lcsh:Q business Digestive System |
| Zdroj: | PLoS ONE, Vol 9, Iss 4, p e94163 (2014) PLoS ONE |
| DOI: | 10.17863/cam.49198 |
| Popis: | BACKGROUND: Barrett's esophagus (BE) occurs as consequence of reflux and is a risk factor for esophageal adenocarcinoma. The current "gold-standard" for diagnosing BE is endoscopy which remains prohibitively expensive and impractical as a population screening tool. We aimed to develop a pre-screening tool to aid decision making for diagnostic referrals. METHODOLOGY/PRINCIPAL FINDINGS: A prospective (training) cohort of 1603 patients attending for endoscopy was used for identification of risk factors to develop a risk prediction model. Factors associated with BE in the univariate analysis were selected to develop prediction models that were validated in an independent, external cohort of 477 non-BE patients referred for endoscopy with symptoms of reflux or dyspepsia. Two prediction models were developed separately for columnar lined epithelium (CLE) of any length and using a stricter definition of intestinal metaplasia (IM) with segments ≥ 2 cm with areas under the ROC curves (AUC) of 0.72 (95%CI: 0.67-0.77) and 0.81 (95%CI: 0.76-0.86), respectively. The two prediction models included demographics (age, sex), symptoms (heartburn, acid reflux, chest pain, abdominal pain) and medication for "stomach" symptoms. These two models were validated in the independent cohort with AUCs of 0.61 (95%CI: 0.54-0.68) and 0.64 (95%CI: 0.52-0.77) for CLE and IM ≥ 2 cm, respectively. CONCLUSIONS: We have identified and validated two prediction models for CLE and IM ≥ 2 cm. Both models have fair prediction accuracies and can select out around 20% of individuals unlikely to benefit from investigation for Barrett's esophagus. Such prediction models have the potential to generate useful cost-savings for BE screening among the symptomatic population. |
| Databáze: | OpenAIRE |
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