Consensus statements for management of Barrett's Dysplasia and early-stage Esophageal Adenocarcinoma, based on a Delphi Process. / Bennett, Cathy; Vakil, Nimish; Bergman, Jacques; Harrison, Rebecca; Odze, Robert; Vieth, Michael; Sanders, Scott; Gay, Laura; Pech, Oliver; Longcroft-Wheaton, Gaius; Romero, Yvonne; Inadomi, John; Tack, Jan; Corley, Douglas A.; Manner, Hendrik; Green, Susi; Al Dulaimi, David; Ali, Haythem; Allum, Bill; Anderson, Mark; Curtis, Howard; Falk, Gary; Fennerty, M. Brian; Fullarton, Grant; Krishnadath, Kausilia; Meltzer, Stephen J.; Armstrong, David; Ganz, Robert; Cengia, Gianpaolo; Going, James J.; Goldblum, John; Gordon, Charles; Grabsch, Heike; Haigh, Chris; Hongo, Michio; Johnston, David; Forbes-Young, Ricky; Kay, Elaine; Kaye, Philip; Lerut, Toni; Lovat, Laurence B.; Lundell, Lars; Mairs, Philip; Shimoda, Tadakuza; Spechler, Stuart; Sontag, Stephen; Malfertheiner, Peter; Murray, Iain; Nanji, Manoj; Poller, David; Ragunath, Krish; Regula, Jaroslaw; Cestari, Renzo; Shepherd, Neil; Singh, Rajvinder; Stein, Hubert J.; Talley, Nicholas J.; Galmiche, Jean-Paul; Tham, Tony C. K.; Watson, Peter; Yerian, Lisa; Rugge, Massimo; Rice, Thomas W.; Hart, John; Gittens, Stuart; Hewin, David; Hochberger, Juergen; Kahrilas, Peter; Preston, Sean; Sampliner, Richard; Sharma, Prateek; Stuart, Robert; Wang, Kenneth; Waxman, Irving; Abley, Chris; Loft, Duncan; Penman, Ian; Shaheen, Nicholas J.; Chak, Amitabh; Davies, Gareth; Dunn, Lorna; Falck-Ytter, Yngve; Decaestecker, John; Bhandari, Pradeep; Ell, Christian; Griffin, Michael; Attwood, Stephen; Barr, Hugh; Allen, John; Ferguson, Mark K.; Moayyedi, Paul; Jankowski, Janusz A. Z.
In: Gastroenterology, Vol. 143, No. 2, 08.2012, p. 336-346.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Consensus statements for management of Barrett's Dysplasia and early-stage Esophageal Adenocarcinoma, based on a Delphi Process
A1 - Bennett,Cathy
A1 - Vakil,Nimish
A1 - Bergman,Jacques
A1 - Harrison,Rebecca
A1 - Odze,Robert
A1 - Vieth,Michael
A1 - Sanders,Scott
A1 - Gay,Laura
A1 - Pech,Oliver
A1 - Longcroft-Wheaton,Gaius
A1 - Romero,Yvonne
A1 - Inadomi,John
A1 - Tack,Jan
A1 - Corley,Douglas A.
A1 - Manner,Hendrik
A1 - Green,Susi
A1 - Al Dulaimi,David
A1 - Ali,Haythem
A1 - Allum,Bill
A1 - Anderson,Mark
A1 - Curtis,Howard
A1 - Falk,Gary
A1 - Fennerty,M. Brian
A1 - Fullarton,Grant
A1 - Krishnadath,Kausilia
A1 - Meltzer,Stephen J.
A1 - Armstrong,David
A1 - Ganz,Robert
A1 - Cengia,Gianpaolo
A1 - Going,James J.
A1 - Goldblum,John
A1 - Gordon,Charles
A1 - Grabsch,Heike
A1 - Haigh,Chris
A1 - Hongo,Michio
A1 - Johnston,David
A1 - Forbes-Young,Ricky
A1 - Kay,Elaine
A1 - Kaye,Philip
A1 - Lerut,Toni
A1 - Lovat,Laurence B.
A1 - Lundell,Lars
A1 - Mairs,Philip
A1 - Shimoda,Tadakuza
A1 - Spechler,Stuart
A1 - Sontag,Stephen
A1 - Malfertheiner,Peter
A1 - Murray,Iain
A1 - Nanji,Manoj
A1 - Poller,David
A1 - Ragunath,Krish
A1 - Regula,Jaroslaw
A1 - Cestari,Renzo
A1 - Shepherd,Neil
A1 - Singh,Rajvinder
A1 - Stein,Hubert J.
A1 - Talley,Nicholas J.
A1 - Galmiche,Jean-Paul
A1 - Tham,Tony C. K.
A1 - Watson,Peter
A1 - Yerian,Lisa
A1 - Rugge,Massimo
A1 - Rice,Thomas W.
A1 - Hart,John
A1 - Gittens,Stuart
A1 - Hewin,David
A1 - Hochberger,Juergen
A1 - Kahrilas,Peter
A1 - Preston,Sean
A1 - Sampliner,Richard
A1 - Sharma,Prateek
A1 - Stuart,Robert
A1 - Wang,Kenneth
A1 - Waxman,Irving
A1 - Abley,Chris
A1 - Loft,Duncan
A1 - Penman,Ian
A1 - Shaheen,Nicholas J.
A1 - Chak,Amitabh
A1 - Davies,Gareth
A1 - Dunn,Lorna
A1 - Falck-Ytter,Yngve
A1 - Decaestecker,John
A1 - Bhandari,Pradeep
A1 - Ell,Christian
A1 - Griffin,Michael
A1 - Attwood,Stephen
A1 - Barr,Hugh
A1 - Allen,John
A1 - Ferguson,Mark K.
A1 - Moayyedi,Paul
A1 - Jankowski,Janusz A. Z.
AU - Bennett,Cathy
AU - Vakil,Nimish
AU - Bergman,Jacques
AU - Harrison,Rebecca
AU - Odze,Robert
AU - Vieth,Michael
AU - Sanders,Scott
AU - Gay,Laura
AU - Pech,Oliver
AU - Longcroft-Wheaton,Gaius
AU - Romero,Yvonne
AU - Inadomi,John
AU - Tack,Jan
AU - Corley,Douglas A.
AU - Manner,Hendrik
AU - Green,Susi
AU - Al Dulaimi,David
AU - Ali,Haythem
AU - Allum,Bill
AU - Anderson,Mark
AU - Curtis,Howard
AU - Falk,Gary
AU - Fennerty,M. Brian
AU - Fullarton,Grant
AU - Krishnadath,Kausilia
AU - Meltzer,Stephen J.
AU - Armstrong,David
AU - Ganz,Robert
AU - Cengia,Gianpaolo
AU - Going,James J.
AU - Goldblum,John
AU - Gordon,Charles
AU - Grabsch,Heike
AU - Haigh,Chris
AU - Hongo,Michio
AU - Johnston,David
AU - Forbes-Young,Ricky
AU - Kay,Elaine
AU - Kaye,Philip
AU - Lerut,Toni
AU - Lovat,Laurence B.
AU - Lundell,Lars
AU - Mairs,Philip
AU - Shimoda,Tadakuza
AU - Spechler,Stuart
AU - Sontag,Stephen
AU - Malfertheiner,Peter
AU - Murray,Iain
AU - Nanji,Manoj
AU - Poller,David
AU - Ragunath,Krish
AU - Regula,Jaroslaw
AU - Cestari,Renzo
AU - Shepherd,Neil
AU - Singh,Rajvinder
AU - Stein,Hubert J.
AU - Talley,Nicholas J.
AU - Galmiche,Jean-Paul
AU - Tham,Tony C. K.
AU - Watson,Peter
AU - Yerian,Lisa
AU - Rugge,Massimo
AU - Rice,Thomas W.
AU - Hart,John
AU - Gittens,Stuart
AU - Hewin,David
AU - Hochberger,Juergen
AU - Kahrilas,Peter
AU - Preston,Sean
AU - Sampliner,Richard
AU - Sharma,Prateek
AU - Stuart,Robert
AU - Wang,Kenneth
AU - Waxman,Irving
AU - Abley,Chris
AU - Loft,Duncan
AU - Penman,Ian
AU - Shaheen,Nicholas J.
AU - Chak,Amitabh
AU - Davies,Gareth
AU - Dunn,Lorna
AU - Falck-Ytter,Yngve
AU - Decaestecker,John
AU - Bhandari,Pradeep
AU - Ell,Christian
AU - Griffin,Michael
AU - Attwood,Stephen
AU - Barr,Hugh
AU - Allen,John
AU - Ferguson,Mark K.
AU - Moayyedi,Paul
AU - Jankowski,Janusz A. Z.
PY - 2012/8
Y1 - 2012/8
N2 - <p>BACKGROUND & AIMS: Esophageal adenocarcinoma (EA) is increasingly common among patients with Barrett's esophagus (BE). We aimed to provide consensus recommendations based on the medical literature that clinicians could use to manage patients with BE and low-grade dysplasia, high-grade dysplasia (HGD), or early-stage EA. METHODS: We performed an international, multidisciplinary, systematic, evidence-based review of different management strategies for patients with BE and dysplasia or early-stage EA. We used a Delphi process to develop consensus statements. The results of literature searches were screened using a unique, interactive, Web-based data-sifting platform; we used 11,904 papers to inform the choice of statements selected. An a priori threshold of 80% agreement was used to establish consensus for each statement. RESULTS: Eighty-one of the 91 statements achieved consensus despite generally low quality of evidence, including 8 clinical statements: (1) specimens from endoscopic resection are better than biopsies for staging lesions, (2) it is important to carefully map the size of the dysplastic areas, (3) patients that receive ablative or surgical therapy require endoscopic follow-up, (4) high-resolution endoscopy is necessary for accurate diagnosis, (5) endoscopic therapy for HGD is preferred to surveillance, (6) endoscopic therapy for HGD is preferred to surgery, (7) the combination of endoscopic resection and radiofrequency ablation is the most effective therapy, and (8) after endoscopic removal of lesions from patients with HGD, all areas of BE should be ablated. CONCLUSIONS: We developed a data-sifting platform and used the Delphi process to create evidence-based consensus statements for the management of patients with BE and early-stage EA. This approach identified important clinical features of the diseases and areas for future studies.</p>
AB - <p>BACKGROUND & AIMS: Esophageal adenocarcinoma (EA) is increasingly common among patients with Barrett's esophagus (BE). We aimed to provide consensus recommendations based on the medical literature that clinicians could use to manage patients with BE and low-grade dysplasia, high-grade dysplasia (HGD), or early-stage EA. METHODS: We performed an international, multidisciplinary, systematic, evidence-based review of different management strategies for patients with BE and dysplasia or early-stage EA. We used a Delphi process to develop consensus statements. The results of literature searches were screened using a unique, interactive, Web-based data-sifting platform; we used 11,904 papers to inform the choice of statements selected. An a priori threshold of 80% agreement was used to establish consensus for each statement. RESULTS: Eighty-one of the 91 statements achieved consensus despite generally low quality of evidence, including 8 clinical statements: (1) specimens from endoscopic resection are better than biopsies for staging lesions, (2) it is important to carefully map the size of the dysplastic areas, (3) patients that receive ablative or surgical therapy require endoscopic follow-up, (4) high-resolution endoscopy is necessary for accurate diagnosis, (5) endoscopic therapy for HGD is preferred to surveillance, (6) endoscopic therapy for HGD is preferred to surgery, (7) the combination of endoscopic resection and radiofrequency ablation is the most effective therapy, and (8) after endoscopic removal of lesions from patients with HGD, all areas of BE should be ablated. CONCLUSIONS: We developed a data-sifting platform and used the Delphi process to create evidence-based consensus statements for the management of patients with BE and early-stage EA. This approach identified important clinical features of the diseases and areas for future studies.</p>
U2 - 10.1053/j.gastro.2012.04.032
DO - 10.1053/j.gastro.2012.04.032
M1 - Article
JO - Gastroenterology
JF - Gastroenterology
SN - 0016-5085
IS - 2
VL - 143
SP - 336
EP - 346
ER -