BOB CAT: a Large-Scale Review and Delphi Consensus for Management of Barrett’s Esophagus With No Dysplasia, Indefinite for, or Low-Grade Dysplasia

Yeng Ang; Cathy Bennett; Paul Moayyedi; Douglas A Corley; John DeCaestecker; Yngve Falck-Ytter; Gary Falk; Nimish Vakil; Scott Sanders; Michael Vieth; John Inadomi; David Aldulaimi; Khek-Yu Ho; Robert Odze; Stephen J Meltzer; Eamonn Quigley; Stuart Gittens; Peter Watson; Giovanni Zaninotto; Prasad G Iyer; Leo Alexandre; James Callaghan; Rebecca Harrison; Rajvinder Singh; Pradeep Bhandari; Raf Bisschops; Bita Geramizadeh; Philip Kaye; Sheila Krishnadath; M Brian Fennerty; Hendrik Manner; Katie S Nason; Oliver Pech; Vani Konda; Krish Ragunath; Imdadur Rahman; Yvonne Romero; Richard Sampliner; Peter D Siersema; Jan Tack; Tony CK Tham; Nigel Trudgill; David S Weinberg; Jean Wang; Kenneth Wang; Jennie YY Wong; Stephen Attwood; Peter Malfertheiner; David MacDonald; Hugh Barr; Mark K Ferguson; Janusz Jankowski

doi:10.1038/ajg.2015.55

BOB CAT: a Large-Scale Review and Delphi Consensus for Management of Barrett’s Esophagus With No Dysplasia, Indefinite for, or Low-Grade Dysplasia

Yeng Ang, Cathy Bennett, Paul Moayyedi, Douglas A Corley, John DeCaestecker, Yngve Falck-Ytter, Gary Falk, Nimish Vakil, Scott Sanders, Michael Vieth, John Inadomi, David Aldulaimi, Khek-Yu Ho, Robert Odze, Stephen J Meltzer, Eamonn Quigley, Stuart Gittens, Peter Watson, Giovanni Zaninotto, Prasad G IyerLeo Alexandre, James Callaghan, Rebecca Harrison, Rajvinder Singh, Pradeep Bhandari, Raf Bisschops, Bita Geramizadeh, Philip Kaye, Sheila Krishnadath, M Brian Fennerty, Hendrik Manner, Katie S Nason, Oliver Pech, Vani Konda, Krish Ragunath, Imdadur Rahman, Yvonne Romero, Richard Sampliner, Peter D Siersema, Jan Tack, Tony CK Tham, Nigel Trudgill, David S Weinberg, Jean Wang, Kenneth Wang, Jennie YY Wong, Stephen Attwood, Peter Malfertheiner, David MacDonald, Hugh Barr, Mark K Ferguson, Janusz Jankowski

Research output: Contribution to journal › Article › peer-review

Abstract

OBJECTIVES: Barrett's esophagus (BE) is a common premalignant lesion for which surveillance is recommended. This strategy is limited by considerable variations in clinical practice. We conducted an international, multidisciplinary, systematic search and evidence-based review of BE and provided consensus recommendations for clinical use in patients with nondysplastic, indefinite, and low-grade dysplasia (LGD). METHODS: We defined the scope, proposed statements, and searched electronic databases, yielding 20,558 publications that were screened, selected online, and formed the evidence base. We used a Delphi consensus process, with an 80% agreement threshold, using GRADE (Grading of Recommendations Assessment, Development and Evaluation) to categorize the quality of evidence and strength of recommendations. RESULTS: In total, 80% of respondents agreed with 55 of 127 statements in the final voting rounds. Population endoscopic screening is not recommended and screening should target only very high-risk cases of males aged over 60 years with chronic uncontrolled reflux. A new international definition of BE was agreed upon. For any degree of dysplasia, at least two specialist gastrointestinal (GI) pathologists are required. Risk factors for cancer include male gender, length of BE, and central obesity. Endoscopic resection should be used for visible, nodular areas. Surveillance is not recommended for

Original language	English
Pages (from-to)	662-682
Number of pages	20
Journal	The American Journal of Gastroenterology
Volume	110
Issue number	5
DOIs	https://doi.org/10.1038/ajg.2015.55
Publication status	Published - 1 May 2015

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1038/ajg.2015.55

Cite this

Ang, Y., Bennett, C., Moayyedi, P., Corley, D. A., DeCaestecker, J., Falck-Ytter, Y., Falk, G., Vakil, N., Sanders, S., Vieth, M., Inadomi, J., Aldulaimi, D., Ho, K.-Y., Odze, R., Meltzer, S. J., Quigley, E., Gittens, S., Watson, P., Zaninotto, G., ... Jankowski, J. (2015). BOB CAT: a Large-Scale Review and Delphi Consensus for Management of Barrett’s Esophagus With No Dysplasia, Indefinite for, or Low-Grade Dysplasia. The American Journal of Gastroenterology, 110(5), 662-682. https://doi.org/10.1038/ajg.2015.55

@article{e34f22ded5304c3185cbac3e39ae449a,

title = "BOB CAT: a Large-Scale Review and Delphi Consensus for Management of Barrett{\textquoteright}s Esophagus With No Dysplasia, Indefinite for, or Low-Grade Dysplasia",

abstract = "OBJECTIVES: Barrett's esophagus (BE) is a common premalignant lesion for which surveillance is recommended. This strategy is limited by considerable variations in clinical practice. We conducted an international, multidisciplinary, systematic search and evidence-based review of BE and provided consensus recommendations for clinical use in patients with nondysplastic, indefinite, and low-grade dysplasia (LGD). METHODS: We defined the scope, proposed statements, and searched electronic databases, yielding 20,558 publications that were screened, selected online, and formed the evidence base. We used a Delphi consensus process, with an 80% agreement threshold, using GRADE (Grading of Recommendations Assessment, Development and Evaluation) to categorize the quality of evidence and strength of recommendations. RESULTS: In total, 80% of respondents agreed with 55 of 127 statements in the final voting rounds. Population endoscopic screening is not recommended and screening should target only very high-risk cases of males aged over 60 years with chronic uncontrolled reflux. A new international definition of BE was agreed upon. For any degree of dysplasia, at least two specialist gastrointestinal (GI) pathologists are required. Risk factors for cancer include male gender, length of BE, and central obesity. Endoscopic resection should be used for visible, nodular areas. Surveillance is not recommended for",

author = "Yeng Ang and Cathy Bennett and Paul Moayyedi and Corley, {Douglas A} and John DeCaestecker and Yngve Falck-Ytter and Gary Falk and Nimish Vakil and Scott Sanders and Michael Vieth and John Inadomi and David Aldulaimi and Khek-Yu Ho and Robert Odze and Meltzer, {Stephen J} and Eamonn Quigley and Stuart Gittens and Peter Watson and Giovanni Zaninotto and Iyer, {Prasad G} and Leo Alexandre and James Callaghan and Rebecca Harrison and Rajvinder Singh and Pradeep Bhandari and Raf Bisschops and Bita Geramizadeh and Philip Kaye and Sheila Krishnadath and Fennerty, {M Brian} and Hendrik Manner and Nason, {Katie S} and Oliver Pech and Vani Konda and Krish Ragunath and Imdadur Rahman and Yvonne Romero and Richard Sampliner and Siersema, {Peter D} and Jan Tack and Tham, {Tony CK} and Nigel Trudgill and Weinberg, {David S} and Jean Wang and Kenneth Wang and Wong, {Jennie YY} and Stephen Attwood and Peter Malfertheiner and David MacDonald and Hugh Barr and Ferguson, {Mark K} and Janusz Jankowski",

year = "2015",

month = may,

day = "1",

doi = "10.1038/ajg.2015.55",

language = "English",

volume = "110",

pages = "662--682",

journal = "The American Journal of Gastroenterology",

issn = "0002-9270",

publisher = "Springer Nature",

number = "5",

}

Ang, Y, Bennett, C, Moayyedi, P, Corley, DA, DeCaestecker, J, Falck-Ytter, Y, Falk, G, Vakil, N, Sanders, S, Vieth, M, Inadomi, J, Aldulaimi, D, Ho, K-Y, Odze, R, Meltzer, SJ, Quigley, E, Gittens, S, Watson, P, Zaninotto, G, Iyer, PG, Alexandre, L, Callaghan, J, Harrison, R, Singh, R, Bhandari, P, Bisschops, R, Geramizadeh, B, Kaye, P, Krishnadath, S, Fennerty, MB, Manner, H, Nason, KS, Pech, O, Konda, V, Ragunath, K, Rahman, I, Romero, Y, Sampliner, R, Siersema, PD, Tack, J, Tham, TCK, Trudgill, N, Weinberg, DS, Wang, J, Wang, K, Wong, JYY, Attwood, S, Malfertheiner, P, MacDonald, D, Barr, H, Ferguson, MK & Jankowski, J 2015, 'BOB CAT: a Large-Scale Review and Delphi Consensus for Management of Barrett’s Esophagus With No Dysplasia, Indefinite for, or Low-Grade Dysplasia', The American Journal of Gastroenterology, vol. 110, no. 5, pp. 662-682. https://doi.org/10.1038/ajg.2015.55

TY - JOUR

T1 - BOB CAT: a Large-Scale Review and Delphi Consensus for Management of Barrett’s Esophagus With No Dysplasia, Indefinite for, or Low-Grade Dysplasia

AU - Ang, Yeng

AU - Bennett, Cathy

AU - Moayyedi, Paul

AU - Corley, Douglas A

AU - DeCaestecker, John

AU - Falck-Ytter, Yngve

AU - Falk, Gary

AU - Vakil, Nimish

AU - Sanders, Scott

AU - Vieth, Michael

AU - Inadomi, John

AU - Aldulaimi, David

AU - Ho, Khek-Yu

AU - Odze, Robert

AU - Meltzer, Stephen J

AU - Quigley, Eamonn

AU - Gittens, Stuart

AU - Watson, Peter

AU - Zaninotto, Giovanni

AU - Iyer, Prasad G

AU - Alexandre, Leo

AU - Callaghan, James

AU - Harrison, Rebecca

AU - Singh, Rajvinder

AU - Bhandari, Pradeep

AU - Bisschops, Raf

AU - Geramizadeh, Bita

AU - Kaye, Philip

AU - Krishnadath, Sheila

AU - Fennerty, M Brian

AU - Manner, Hendrik

AU - Nason, Katie S

AU - Pech, Oliver

AU - Konda, Vani

AU - Ragunath, Krish

AU - Rahman, Imdadur

AU - Romero, Yvonne

AU - Sampliner, Richard

AU - Siersema, Peter D

AU - Tack, Jan

AU - Tham, Tony CK

AU - Trudgill, Nigel

AU - Weinberg, David S

AU - Wang, Jean

AU - Wang, Kenneth

AU - Wong, Jennie YY

AU - Attwood, Stephen

AU - Malfertheiner, Peter

AU - MacDonald, David

AU - Barr, Hugh

AU - Ferguson, Mark K

AU - Jankowski, Janusz

PY - 2015/5/1

Y1 - 2015/5/1

N2 - OBJECTIVES: Barrett's esophagus (BE) is a common premalignant lesion for which surveillance is recommended. This strategy is limited by considerable variations in clinical practice. We conducted an international, multidisciplinary, systematic search and evidence-based review of BE and provided consensus recommendations for clinical use in patients with nondysplastic, indefinite, and low-grade dysplasia (LGD). METHODS: We defined the scope, proposed statements, and searched electronic databases, yielding 20,558 publications that were screened, selected online, and formed the evidence base. We used a Delphi consensus process, with an 80% agreement threshold, using GRADE (Grading of Recommendations Assessment, Development and Evaluation) to categorize the quality of evidence and strength of recommendations. RESULTS: In total, 80% of respondents agreed with 55 of 127 statements in the final voting rounds. Population endoscopic screening is not recommended and screening should target only very high-risk cases of males aged over 60 years with chronic uncontrolled reflux. A new international definition of BE was agreed upon. For any degree of dysplasia, at least two specialist gastrointestinal (GI) pathologists are required. Risk factors for cancer include male gender, length of BE, and central obesity. Endoscopic resection should be used for visible, nodular areas. Surveillance is not recommended for

AB - OBJECTIVES: Barrett's esophagus (BE) is a common premalignant lesion for which surveillance is recommended. This strategy is limited by considerable variations in clinical practice. We conducted an international, multidisciplinary, systematic search and evidence-based review of BE and provided consensus recommendations for clinical use in patients with nondysplastic, indefinite, and low-grade dysplasia (LGD). METHODS: We defined the scope, proposed statements, and searched electronic databases, yielding 20,558 publications that were screened, selected online, and formed the evidence base. We used a Delphi consensus process, with an 80% agreement threshold, using GRADE (Grading of Recommendations Assessment, Development and Evaluation) to categorize the quality of evidence and strength of recommendations. RESULTS: In total, 80% of respondents agreed with 55 of 127 statements in the final voting rounds. Population endoscopic screening is not recommended and screening should target only very high-risk cases of males aged over 60 years with chronic uncontrolled reflux. A new international definition of BE was agreed upon. For any degree of dysplasia, at least two specialist gastrointestinal (GI) pathologists are required. Risk factors for cancer include male gender, length of BE, and central obesity. Endoscopic resection should be used for visible, nodular areas. Surveillance is not recommended for

U2 - 10.1038/ajg.2015.55

DO - 10.1038/ajg.2015.55

M3 - Article

SN - 0002-9270

VL - 110

SP - 662

EP - 682

JO - The American Journal of Gastroenterology

JF - The American Journal of Gastroenterology

IS - 5

ER -

BOB CAT: a Large-Scale Review and Delphi Consensus for Management of Barrett’s Esophagus With No Dysplasia, Indefinite for, or Low-Grade Dysplasia

Abstract

UN SDGs

Access to Document

Fingerprint

Cite this