Tools accurately identify risk for neoplastic BE vs frequency, duration of GERD
Detection tools more accurately identified patients at risk for neoplastic Barrett’s esophagus compared with frequency and duration of GERD, according to results published in Gastroenterology.
“The HUNT, M-BERET, and Kunzmann tools identify patients with BE with [area under the receiver operating characteristic curve (AUROC)] values ranging from 0.665 to 0.695, and discriminate patients with early neoplasia from patients without BE with AUROC values ranging from 0.763 to 0.796,” Joel H. Rubenstein, MD, from the division of gastroenterology and department of internal medicine at the University of Michigan Medical School in Ann Arbor and colleagues wrote.
Rubenstein and colleagues conducted a prospective study of 1,242 patients, aged 40 to 79 years, who presented with their first esophagogastroduodenoscopy or their first endoscopic therapy of early neoplastic BE between April 2015 and June 2018. Investigators calculated risk scores for six published tools: Gerson, Locke, Thrift, Michigan BE pREdiction Tool (M-BERET), Nord-Trøndelag Health Study (HUNT), and Kunzmann tools. They also examined the accuracy of frequency and duration of GERD with data randomly selected from 50% of patients who underwent their first EGD. Findings from endoscopy served as the reference standard to compare the ability of the tools to differentiate patients with BE and early neoplasia in patients without BE.
Eighty-one of 1,152 patients received a BE diagnosis during their first EGD. Investigators reported GERD symptoms alone identified patients with BE with an AUROC of 0.579. They also wrote all tools were more accurate in identifying patients with BE compared with frequency and duration of GERD. Also, predicted risk was well associated with observed risk. The AUROCs of the HUNT tool (0.796), the M-BERET (0.773) and the Kunzmann tool (0.763) were similar in differentiating between patients with early neoplasia (n = 94) vs. patients with no BE.
“Each tool was more accurate in discriminating BE with early neoplasia than GERD frequency and duration alone (AUROC, 0.667),” Rubenstein and colleagues wrote.