Adherence to guideline recommendations for Barrett's esophagus (BE) surveillance endoscopies: Effects of dedicated BE endoscopy lists

I N Beaufort; A N Milne; Y A Alderlieste; J E Baars; P R Bos; J P W Burger; N C M van Heel; M Ledeboer; R J Lieverse; P C van de Meeberg; J J Meeuse; A H J Naber; H J M Pullens; R C H Scheffer; M Sikkema; R E Verbeek; M A M T Verhagen; W van de Vrie; M Willems; B L A M Weusten

doi:10.1055/a-2125-0161

Adherence to guideline recommendations for Barrett's esophagus (BE) surveillance endoscopies: Effects of dedicated BE endoscopy lists

I N Beaufort, A N Milne, Y A Alderlieste, J E Baars, P R Bos, J P W Burger, N C M van Heel, M Ledeboer, R J Lieverse, P C van de Meeberg, J J Meeuse, A H J Naber, H J M Pullens, R C H Scheffer, M Sikkema, R E Verbeek, M A M T Verhagen, W van de Vrie, M Willems, B L A M Weusten

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Abstract

Background and study aims For non-dysplastic Barrett's Esophagus (BE) patients, guidelines recommend endoscopic surveillance every 3 to 5 years with four-quadrant random biopsies every 2 cm of BE length. Adherence to these guidelines is low in clinical practice. Pooling BE surveillance endoscopies on dedicated endoscopy lists performed by dedicated endoscopists could possibly enhance guideline adherence, detection of visible lesions, and dysplasia detection rates (DDRs). Patients and methods Data were used from the ACID-study (Netherlands Trial Registry NL8214), a prospective trial of BE surveillance in the Netherlands. BE patients with known or previously treated dysplasia were excluded. Guideline adherence, detection of visible lesions, and DDRs were compared for patients on dedicated and general endoscopy lists. Results A total of 1,244 patients were included, 318 on dedicated lists and 926 on general lists. Endoscopies on dedicated lists showed significantly higher adherence to the random biopsy protocol (85% vs. 66%, P <0.01) and recommended surveillance intervals (60% vs. 47%, P <0.01) compared to general lists. Detection of visible lesions (8.8% vs. 8.1%, P =0.79) and DDRs were not significantly different (6.9% and 6.6%, P =0.94). None (0.0%) of the patients scheduled on dedicated lists and 10 (1.1%) on general lists were diagnosed with esophageal adenocarcinoma ( P =0.07). In multivariable analysis, dedicated lists were significantly associated with biopsy protocol adherence and adherence to surveillance interval recommendations with odds ratios of 4.45 (95% confidence interval [CI] 2.07-9.57) and 1.64 (95% CI 1.03-2.61), respectively. Conclusions Dedicated endoscopy lists are associated with better adherence to the random biopsy protocol and surveillance interval recommendations.

Original language	English
Pages (from-to)	E952-E962
Journal	Endoscopy international open
Volume	11
Issue number	10
DOIs	https://doi.org/10.1055/a-2125-0161
Publication status	Published - Oct 2023

Keywords

Endoscopy Upper GI Tract - Reflux disease - Barretts and adenocarcinoma - Diagnosis and imaging (inc chromoendoscopy
NBI
iSCAN
FICE
CLE)

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Beaufort, I. N., Milne, A. N., Alderlieste, Y. A., Baars, J. E., Bos, P. R., Burger, J. P. W., van Heel, N. C. M., Ledeboer, M., Lieverse, R. J., van de Meeberg, P. C., Meeuse, J. J., Naber, A. H. J., Pullens, H. J. M., Scheffer, R. C. H., Sikkema, M., Verbeek, R. E., Verhagen, M. A. M. T., van de Vrie, W., Willems, M., & Weusten, B. L. A. M. (2023). Adherence to guideline recommendations for Barrett's esophagus (BE) surveillance endoscopies: Effects of dedicated BE endoscopy lists. Endoscopy international open, 11(10), E952-E962. https://doi.org/10.1055/a-2125-0161

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title = "Adherence to guideline recommendations for Barrett's esophagus (BE) surveillance endoscopies: Effects of dedicated BE endoscopy lists",

abstract = " Background and study aims For non-dysplastic Barrett's Esophagus (BE) patients, guidelines recommend endoscopic surveillance every 3 to 5 years with four-quadrant random biopsies every 2 cm of BE length. Adherence to these guidelines is low in clinical practice. Pooling BE surveillance endoscopies on dedicated endoscopy lists performed by dedicated endoscopists could possibly enhance guideline adherence, detection of visible lesions, and dysplasia detection rates (DDRs). Patients and methods Data were used from the ACID-study (Netherlands Trial Registry NL8214), a prospective trial of BE surveillance in the Netherlands. BE patients with known or previously treated dysplasia were excluded. Guideline adherence, detection of visible lesions, and DDRs were compared for patients on dedicated and general endoscopy lists. Results A total of 1,244 patients were included, 318 on dedicated lists and 926 on general lists. Endoscopies on dedicated lists showed significantly higher adherence to the random biopsy protocol (85% vs. 66%, P <0.01) and recommended surveillance intervals (60% vs. 47%, P <0.01) compared to general lists. Detection of visible lesions (8.8% vs. 8.1%, P =0.79) and DDRs were not significantly different (6.9% and 6.6%, P =0.94). None (0.0%) of the patients scheduled on dedicated lists and 10 (1.1%) on general lists were diagnosed with esophageal adenocarcinoma ( P =0.07). In multivariable analysis, dedicated lists were significantly associated with biopsy protocol adherence and adherence to surveillance interval recommendations with odds ratios of 4.45 (95% confidence interval [CI] 2.07-9.57) and 1.64 (95% CI 1.03-2.61), respectively. Conclusions Dedicated endoscopy lists are associated with better adherence to the random biopsy protocol and surveillance interval recommendations. ",

keywords = "Endoscopy Upper GI Tract - Reflux disease - Barretts and adenocarcinoma - Diagnosis and imaging (inc chromoendoscopy, NBI, iSCAN, FICE, CLE)",

author = "Beaufort, {I N} and Milne, {A N} and Alderlieste, {Y A} and Baars, {J E} and Bos, {P R} and Burger, {J P W} and {van Heel}, {N C M} and M Ledeboer and Lieverse, {R J} and {van de Meeberg}, {P C} and Meeuse, {J J} and Naber, {A H J} and Pullens, {H J M} and Scheffer, {R C H} and M Sikkema and Verbeek, {R E} and Verhagen, {M A M T} and {van de Vrie}, W and M Willems and Weusten, {B L A M}",

note = "The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).",

year = "2023",

month = oct,

doi = "10.1055/a-2125-0161",

language = "English",

volume = "11",

pages = "E952--E962",

number = "10",

}

Beaufort, IN, Milne, AN, Alderlieste, YA, Baars, JE, Bos, PR, Burger, JPW, van Heel, NCM, Ledeboer, M, Lieverse, RJ, van de Meeberg, PC, Meeuse, JJ, Naber, AHJ, Pullens, HJM, Scheffer, RCH, Sikkema, M, Verbeek, RE, Verhagen, MAMT, van de Vrie, W, Willems, M & Weusten, BLAM 2023, 'Adherence to guideline recommendations for Barrett's esophagus (BE) surveillance endoscopies: Effects of dedicated BE endoscopy lists', Endoscopy international open, vol. 11, no. 10, pp. E952-E962. https://doi.org/10.1055/a-2125-0161

TY - JOUR

T1 - Adherence to guideline recommendations for Barrett's esophagus (BE) surveillance endoscopies

T2 - Effects of dedicated BE endoscopy lists

AU - Beaufort, I N

AU - Milne, A N

AU - Alderlieste, Y A

AU - Baars, J E

AU - Bos, P R

AU - Burger, J P W

AU - van Heel, N C M

AU - Ledeboer, M

AU - Lieverse, R J

AU - van de Meeberg, P C

AU - Meeuse, J J

AU - Naber, A H J

AU - Pullens, H J M

AU - Scheffer, R C H

AU - Sikkema, M

AU - Verbeek, R E

AU - Verhagen, M A M T

AU - van de Vrie, W

AU - Willems, M

AU - Weusten, B L A M

N1 - The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

PY - 2023/10

Y1 - 2023/10

N2 - Background and study aims For non-dysplastic Barrett's Esophagus (BE) patients, guidelines recommend endoscopic surveillance every 3 to 5 years with four-quadrant random biopsies every 2 cm of BE length. Adherence to these guidelines is low in clinical practice. Pooling BE surveillance endoscopies on dedicated endoscopy lists performed by dedicated endoscopists could possibly enhance guideline adherence, detection of visible lesions, and dysplasia detection rates (DDRs). Patients and methods Data were used from the ACID-study (Netherlands Trial Registry NL8214), a prospective trial of BE surveillance in the Netherlands. BE patients with known or previously treated dysplasia were excluded. Guideline adherence, detection of visible lesions, and DDRs were compared for patients on dedicated and general endoscopy lists. Results A total of 1,244 patients were included, 318 on dedicated lists and 926 on general lists. Endoscopies on dedicated lists showed significantly higher adherence to the random biopsy protocol (85% vs. 66%, P <0.01) and recommended surveillance intervals (60% vs. 47%, P <0.01) compared to general lists. Detection of visible lesions (8.8% vs. 8.1%, P =0.79) and DDRs were not significantly different (6.9% and 6.6%, P =0.94). None (0.0%) of the patients scheduled on dedicated lists and 10 (1.1%) on general lists were diagnosed with esophageal adenocarcinoma ( P =0.07). In multivariable analysis, dedicated lists were significantly associated with biopsy protocol adherence and adherence to surveillance interval recommendations with odds ratios of 4.45 (95% confidence interval [CI] 2.07-9.57) and 1.64 (95% CI 1.03-2.61), respectively. Conclusions Dedicated endoscopy lists are associated with better adherence to the random biopsy protocol and surveillance interval recommendations.

AB - Background and study aims For non-dysplastic Barrett's Esophagus (BE) patients, guidelines recommend endoscopic surveillance every 3 to 5 years with four-quadrant random biopsies every 2 cm of BE length. Adherence to these guidelines is low in clinical practice. Pooling BE surveillance endoscopies on dedicated endoscopy lists performed by dedicated endoscopists could possibly enhance guideline adherence, detection of visible lesions, and dysplasia detection rates (DDRs). Patients and methods Data were used from the ACID-study (Netherlands Trial Registry NL8214), a prospective trial of BE surveillance in the Netherlands. BE patients with known or previously treated dysplasia were excluded. Guideline adherence, detection of visible lesions, and DDRs were compared for patients on dedicated and general endoscopy lists. Results A total of 1,244 patients were included, 318 on dedicated lists and 926 on general lists. Endoscopies on dedicated lists showed significantly higher adherence to the random biopsy protocol (85% vs. 66%, P <0.01) and recommended surveillance intervals (60% vs. 47%, P <0.01) compared to general lists. Detection of visible lesions (8.8% vs. 8.1%, P =0.79) and DDRs were not significantly different (6.9% and 6.6%, P =0.94). None (0.0%) of the patients scheduled on dedicated lists and 10 (1.1%) on general lists were diagnosed with esophageal adenocarcinoma ( P =0.07). In multivariable analysis, dedicated lists were significantly associated with biopsy protocol adherence and adherence to surveillance interval recommendations with odds ratios of 4.45 (95% confidence interval [CI] 2.07-9.57) and 1.64 (95% CI 1.03-2.61), respectively. Conclusions Dedicated endoscopy lists are associated with better adherence to the random biopsy protocol and surveillance interval recommendations.

KW - Endoscopy Upper GI Tract - Reflux disease - Barretts and adenocarcinoma - Diagnosis and imaging (inc chromoendoscopy

KW - NBI

KW - iSCAN

KW - FICE

KW - CLE)

U2 - 10.1055/a-2125-0161

DO - 10.1055/a-2125-0161

M3 - Article

C2 - 37828974

SN - 2364-3722

VL - 11

SP - E952-E962

JO - Endoscopy international open

JF - Endoscopy international open

IS - 10

ER -

Adherence to guideline recommendations for Barrett's esophagus (BE) surveillance endoscopies: Effects of dedicated BE endoscopy lists

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Keywords

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