A randomized comparative effectiveness trial of novel endoscopic techniques and approaches for Barrett's esophagus screening in the community.
A randomized comparative effectiveness trial of novel endoscopic techniques and approaches for Barrett's esophagus screening in the community.
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DOI：
10.1038/ajg.2014.362
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发表时间：
2015-01
影响因子：
9.8
通讯作者：
Iyer, Prasad G.
中科院分区：
文献类型：
--
作者：
Sami, Sarmed S.;Dunagan, Kelly T.;Johnson, Michele L.;Schleck, Cathy D.;Shah, Nilay D.;Zinsmeister, Alan R.;Wongkeesong, Louis-Michel;Wang, Kenneth K.;Katzka, David A.;Ragunath, Krish;Iyer, Prasad G.
在以人群为基础的队列中，比较镇静内窥镜（sEGD）与非镇静经鼻内窥镜（uTNE）用于食管评估和巴雷特食管（BE）筛查的参与率和临床效果。前瞻性，随机，对照试验在社区人群。年龄≥50岁且先前已完成验证的胃肠道症状问卷调查的受试者被随机（按年龄、性别和反流症状分层）分为三种筛查技术（sEGD或移动研究车（muTNE）中的uTNE，或医院门诊内窥镜室（huTNE）中的uTNE）之一，并被邀请参加。459名受试者中有209名（46%）同意参与（muTNE n=76, huTNE n=72, sEGD n=61）。与sEGD组（40.7%）相比，muTNE组（47.5%）和huTNE组（45.7%）的非镇静组的参与率更高，但无统计学差异（p=0.27）。使用muTNE（99%）、huTNE（96%）和sEGD（100%）技术对食管的完整评估相似（p=0.08）。sEGD的平均恢复时间（67.3分钟）比muTNE（15.5分钟）和huTNE（18.5分钟）更长（p<0.001）。大约80%的uTNE受试者愿意在未来再次接受该手术。29%和7.8%的受试者分别患有食管炎和BE。移动面包车和临床uTNE筛查具有与sEGD相似的临床有效性，参与率和安全性相似。uTNE的评估时间明显缩短。≥50岁的社区受试者中BE和食管炎的患病率很高。移动和门诊非镇静技术可能为食管评估和BE筛查提供sEGD的有效替代策略。
To compare participation rates and clinical effectiveness of sedated endoscopy (sEGD) versus unsedated transnasal endoscopy (uTNE) for esophageal assessment and Barrett's esophagus (BE) screening in a population-based cohort. Prospective, randomized, controlled trial in a community population. Subjects, ≥ 50 years of age who previously completed validated gastrointestinal symptom questionnaires were randomized (stratified by age, sex and reflux symptoms) to one of three screening techniques (either sEGD, or uTNE in a mobile research van (muTNE), or uTNE in a hospital outpatient endoscopy suite (huTNE)) and invited to participate. 209 of 459 (46%) subjects agreed to participate (muTNE n=76, huTNE n=72, sEGD n=61). Participation rates were numerically higher in the unsedated arms of muTNE (47.5%) and huTNE (45.7%) compared to the sEGD arm (40.7%), but were not statistically different (p=0.27). Complete evaluation of the esophagus was similar using muTNE (99%), huTNE (96%) and sEGD (100%) techniques (p=0.08). Mean recovery times (minutes) were longer for sEGD (67.3) compared to muTNE (15.5) and huTNE (18.5) (p<0.001). Approximately, 80% of uTNE subjects were willing to undergo the procedure again in future. 29% and 7.8% of participating subjects had esophagitis and BE respectively. Mobile van and clinic uTNE screening had comparable clinical effectiveness with similar participation rates and safety profile to sEGD. Evaluation time with uTNE was significantly shorter. Prevalence of BE and esophagitis in community subjects ≥ 50 years of age was substantial. Mobile and outpatient unsedated techniques may provide an effective alternative strategy to sEGD for esophageal assessment and BE screening.
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影响因子：
9.8
作者：
Jung, Kee Wook;Talley, Nicholas J.;Romero, Yvonne;Katzka, David A.;Schleck, Cathy D.;Zinsmeister, Alan R.;Dunagan, Kelly T.;Lutzke, Lori S.;Wu, Tsung-Teh;Wang, Kenneth K.;Frederickson, Mary;Geno, Debra M.;Locke, G. Richard;Prasad, Ganapathy A.
通讯作者：
Prasad, Ganapathy A.
影响因子：
7.7
作者：
Peery AF;Hoppo T;Garman KS;Dellon ES;Daugherty N;Bream S;Sanz AF;Davison J;Spacek M;Connors D;Faulx AL;Chak A;Luketich JD;Shaheen NJ;Jobe BA;Barrett's Esophagus Risk Consortium
通讯作者：
Barrett's Esophagus Risk Consortium
影响因子：
3.1
作者：
Gupta, Milli;Beebe, Timothy J.;Dunagan, Kelly T.;Schleck, Cathy D.;Zinsmeister, Alan R.;Talley, Nicholas J.;Locke, G. Richard, III;Iyer, Prasad G.
通讯作者：
Iyer, Prasad G.
影响因子：
24.5
作者：
Fitzgerald, Rebecca C.;di Pietro, Massimiliano;de Caestecker, John
通讯作者：
de Caestecker, John
影响因子：
1.3
作者：
Mauad, Edmundo Carvalho;Nicolau, Sergio Mancini;Baracat, Edmund C.
通讯作者：
Baracat, Edmund C.