John M. Inadomi, MD; Richard Sampliner, MD; Jesper Lagergren, MD; David Lieberman, MD; A Mark Fendrick, MD; Nimish Vakil, MD
Grant Support: By Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service grant IIR 99-238-2 and an American College of Gastroenterology Faculty Development Award (Dr. Inadomi).
Potential Conflicts of Interest:Consultancies: A.M. Fendrick, N. Vakil; Honoraria: R. Sampliner, A.M. Fendrick, N. Vakil; Grants received: R. Sampliner, A.M. Fendrick, N. Vakil; Grants pending: R. Sampliner; Other: A.M. Fendrick.
Requests for Single Reprints: Nimish Vakil, MD, Division of Gastroenterology, University of Wisconsin Medical School, Aurora Sinai Medical Center, 945 North 12th Street, Room 4040, Milwaukee, WI 53233; e-mail, email@example.com.
Current Author Addresses: Dr. Inadomi: Veterans Affairs Ann Arbor Health Systems (111-D), 2215 Fuller Road, Ann Arbor, MI 48105.
Dr. Sampliner: Southern Arizona Veterans Affairs Healthcare System, 3601 South Sixth Avenue (111G-1), Tucson, AZ 85723.
Dr. Lagergren: Department of Medical Epidemiology, Karolinska Institute, Box 281, S-171 77 Stockholm, Sweden.
Dr. Lieberman: Portland Veterans Affairs Hospital (111A), 3710 Southwest U.S. Veterans Hospital Road, PO Box 1034, Portland, OR 97207.
Dr. Fendrick: University of Michigan Medical Center, 300 NIB, Room Ni7C27, 865 Brookside Drive, Ann Arbor, MI 48105.
Dr. Vakil: Division of Gastroenterology, Aurora Sinai Medical Center, 945 North 12th Street, Room 4040, Milwaukee, WI 53233.
Author Contributions: Conception and design: J.M. Inadomi, R. Sampliner, J. Lagergren, A.M. Fendrick, N. Vakil.
Analysis and interpretation of the data: J.M. Inadomi, J. Lagergren, D. Lieberman, A.M. Fendrick, N. Vakil.
Drafting of the article: J.M. Inadomi, J. Lagergren, D. Lieberman, A.M. Fendrick, N. Vakil.
Critical revision of the article for important intellectual content: J.M. Inadomi, R. Sampliner, J. Lagergren, D. Lieberman, A.M. Fendrick, N. Vakil.
Final approval of the article: J.M. Inadomi, R. Sampliner, J. Lagergren, D. Lieberman, A.M. Fendrick, N. Vakil.
Provision of study materials or patients: J.M. Inadomi, R. Sampliner, N. Vakil.
Statistical expertise: J.M. Inadomi, N. Vakil.
Obtaining of funding: J.M. Inadomi.
Administrative, technical, or logistic support: J.M. Inadomi, N. Vakil.
Collection and assembly of data: J.M. Inadomi, N. Vakil.
Inadomi J., Sampliner R., Lagergren J., Lieberman D., Fendrick A., Vakil N.; Screening and Surveillance for Barrett Esophagus in High-Risk Groups: A Cost–Utility Analysis. Ann Intern Med. 2003;138:176-186. doi: 10.7326/0003-4819-138-3-200302040-00009
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Published: Ann Intern Med. 2003;138(3):176-186.
Current guidelines from the American College of Gastroenterology recommend surveillance to detect cancer and dysplasia in patients with Barrett esophagus, a columnar-cell metaplasia that replaces the native squamous-cell epithelium of the distal esophagus (1). The costs and benefits of surveillance have been evaluated in retrospective studies (2-5) and formal decision analyses (6, 7). Barrett esophagus alone does not cause symptoms that would prompt endoscopic evaluation, and the question of whether screening strategies to detect Barrett esophagus are reasonable and, if so, in which patients is unresolved (8). Adding to the uncertainty is emerging evidence from prospective studies that the incidence of cancer in patients with Barrett esophagus may be considerably lower than previously reported (9, 10). In the absence of randomized, controlled trials of screening and surveillance in Barrett esophagus, the costs and benefits of strategies to decrease mortality rates from cancer are unknown.
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Gastroenterology/Hepatology, Esophageal Disorders.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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