title: Health-related quality of life in patients with Barrett's esophagus: a systematic review.
abstract: OBJECTIVE
  Barrett's esophagus (BE) affects approximately 10% of patients with chronic gastroesophageal reflux disease (GERD). Patients with BE are at risk for reduced health-related quality of life (HRQoL) associated with GERD, in addition to the potential psychosocial stress of carrying a diagnosis of a premalignant condition with a risk of esophageal adenocarcinoma. We sought to systematically review the published literature on HRQoL of patients with BE.
  
  
  METHODS
  We searched PubMed, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature for relevant clinical trials using a defined search strategy. We also manually searched relevant scientific meeting abstracts and related article bibliographies. Eligible articles were case series, cohort studies, or clinical trials that included one or more measures of HRQoL and/or quantitatively assessed burden of disease in patients with BE. Effect sizes were calculated when possible.
  
  
  RESULTS
  Our initial search identified 95 articles. After 2 physician reviews, 25 articles met inclusion criteria. Data show that BE is associated with a significant decrement in HRQoL as measured by both generic and disease-targeted instruments. In addition, patients with BE are at risk for psychological consequences such as depression, anxiety, and stress, which may be related to their increased risk of esophageal adenocarcinoma. Compared with subjects with GERD alone or the general population, a diagnosis of BE also leads to increased health care use and spending.
  
  
  CONCLUSIONS
  BE compromises multiple facets of patients' quality of life. Physicians and researchers should incorporate patient-reported outcomes data including HRQoL measures when treating or studying patients with BE.
authors.affiliation: Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina 27599-7080, USA. seth_crockett@med.unc.edu
authors.forename: Seth D
authors.initials: SD
authors.lastname: Crockett
authors.forename: Quinn K
authors.initials: QK
authors.lastname: Lippmann
authors.forename: Evan S
authors.initials: ES
authors.lastname: Dellon
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Shaheen
mesh_terms: D001471:Barrett Esophagus / Q000473:pathology / Q000503:physiopathology / Q000523:psychology*; D006801:Humans; D011788:Quality of Life / Q000523:psychology*