title: Quality indicators for the management of Barrett's esophagus, dysplasia, and esophageal adenocarcinoma: international consensus recommendations from the American Gastroenterological Association Symposium.
abstract: The development of and adherence to quality indicators in gastroenterology, as in all of medicine, is increasing in importance to ensure that patients receive consistent high-quality care. In addition, government-based and private insurers will be expecting documentation of the parameters by which we measure quality, which will likely affect reimbursements. Barrett's esophagus remains a particularly important disease entity for which we should maintain up-to-date guidelines, given its commonality, potentially lethal outcomes, and controversies regarding screening and surveillance. To achieve this goal, a relatively large group of international experts was assembled and, using the modified Delphi method, evaluated the validity of multiple candidate quality indicators for the diagnosis and management of Barrett's esophagus. Several candidate quality indicators achieved >80% agreement. These statements are intended to serve as a consensus on candidate quality indicators for those who treat patients with Barrett's esophagus.
authors: University of Kansas School of Medicine, Kansas City, Kansas; Veterans Affairs Medical Center, Kansas City, Missouri. Electronic address: psharma@kumc.edu.
authors: Prateek
authors: P
authors: Sharma
authors: Mayo Clinic, Rochester, Minnesota.
authors: David A
authors: DA
authors: Katzka
authors: Department of Gastroenterology and Hepatology, Loyola University Medical Center, Maywood, Illinois.
authors: Neil
authors: N
authors: Gupta
authors: University of Texas, Anderson Cancer Center, Houston, Texas.
authors: Jaffer
authors: J
authors: Ajani
authors: Mayo Clinic, Rochester, Minnesota.
authors: Navtej
authors: N
authors: Buttar
authors: Case Western Reserve University, Cleveland, Ohio.
authors: Amitabh
authors: A
authors: Chak
authors: Kaiser Permanente Northern California, Oakland, California.
authors: Douglas
authors: D
authors: Corley
authors: Baylor College of Medicine, Houston, Texas.
authors: Hashem
authors: H
authors: El-Serag
authors: University of Pennsylvania, Philadelphia, Pennsylvania.
authors: Gary W
authors: GW
authors: Falk
authors: MRC Cancer Cell Unit, Hutchison-MRC Research Center and University of Cambridge, Cambridge, UK.
authors: Rebecca
authors: R
authors: Fitzgerald
authors: Anatomic Pathology, The Cleveland Clinic, Cleveland, Ohio.
authors: John
authors: J
authors: Goldblum
authors: State University of New York at Downstate Medical Center, New York, New York.
authors: Frank
authors: F
authors: Gress
authors: Memorial Sloan Kettering Cancer Center, New York, New York.
authors: David H
authors: DH
authors: Ilson
authors: University of Washington Medical Center, Seattle, Washington.
authors: John M
authors: JM
authors: Inadomi
authors: Erasmus MC University Medical Center, Rotterdam, Netherlands.
authors: Ernest J
authors: EJ
authors: Kuipers
authors: University of Pennsylvania, Philadelphia, Pennsylvania.
authors: John P
authors: JP
authors: Lynch
authors: National University Health System, Singapore and University of Connecticut, Farmington, Connecticut.
authors: Frank
authors: F
authors: McKeon
authors: University of Pennsylvania, Philadelphia, Pennsylvania.
authors: David
authors: D
authors: Metz
authors: The Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors: Pankaj J
authors: PJ
authors: Pasricha
authors: Kranhenhaus Barmherzige Brüder, Regensburg, Germany.
authors: Oliver
authors: O
authors: Pech
authors: Vanderbilt University Medical Center, Nashville, Tennessee.
authors: Richard
authors: R
authors: Peek
authors: Case Western Reserve University, Cleveland, Ohio.
authors: Jeffrey H
authors: JH
authors: Peters
authors: Humanitas Research Hospital, Milan, Italy.
authors: Alessandro
authors: A
authors: Repici
authors: Klinik Hirslanden, Zurich, Switzerland.
authors: Stefan
authors: S
authors: Seewald
authors: University of North Carolina School of Medicine, Chapel Hill, North Carolina.
authors: Nicholas J
authors: NJ
authors: Shaheen
authors: University of Texas Southwestern Medical Center and VA North Texas Healthcare System, Dallas, Texas.
authors: Rhonda F
authors: RF
authors: Souza
authors: University of Texas Southwestern Medical Center and VA North Texas Healthcare System, Dallas, Texas.
authors: Stuart J
authors: SJ
authors: Spechler
authors: Veterans Affairs Medical Center, Kansas City, Missouri.
authors: Prashanth
authors: P
authors: Vennalaganti
authors: Mayo Clinic, Rochester, Minnesota.
authors: Kenneth
authors: K
authors: Wang
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D001471:Barrett Esophagus / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D032921:Consensus; D003245:Consensus Statements as Topic; D019468:Disease Management; D018450:Disease Progression; D004938:Esophageal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D004945:Esophagoscopy; D004947:Esophagus / Q000473:pathology*; D005762:Gastroenterology / Q000458:organization & administration*; D006801:Humans; D014481:United States
keywords: Barrett’s Esophagus; Barrett’s Surveillance; Consensus Statements; Endoscopic Mucosal Resection; Esophageal Adenocarcinoma; Gastroesophageal Reflux Disease; High-Grade Dysplasia; Low-Grade Dysplasia; Metastatic Esophageal Adenocarcinoma; Prague Criteria; Proton Pump Inhibitors; Quality Indicators; Radiofrequency Ablation