Screening for Barrett's in Otolaryngology Patients

耳鼻喉科患者的巴雷特氏病筛查

• 批准号: 6712315
• 负责人: BLAIR Anderson JOBE
• 金额: $ 13.31万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-02-01 至 2008-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6712315
• 关键词: Barretts esophagus; bioimaging /biomedical imaging; cancer risk; clinical research; diagnosis quality /standard; endoscopy; gastrointestinal imaging /visualization; human subject; neoplasm /cancer diagnosis; neoplasm /cancer epidemiology; patient oriented research; reflux esophagitis

DESCRIPTION (provided by applicant): This application proposes a training program to develop Blair A. Jobe, MD into an independent clinician-scientist specializing in investigations of Barrett's esophagus and esophageal cancer. Dr. Jobe is a board certified General Surgeon with subspecialty training in laparoscopic and esophageal surgery. The mentored career development plan consists of a three-tiered approach: a didactic education resulting in a Masters in Clinical Investigation degree, a broad-based experiential learning program, and a mentored clinical research experience. The primary goal of this program will be for Dr. Jobe to achieve independence as a clinical investigator in all respects. Dr. Jobe is currently enrolled in the Human Investigations Program at Oregon Health and Science University (OHSU). This is a two year K30 (NIH) sponsored program for the purposes of developing patient-oriented research skills. Mentored research will be conducted under the direction of a mentorship committee composed of Dr. Cynthia Morris, Professor of Medical Informatics and Outcomes Research, OHSU, Dr. David Lieberman, Chief, Division of Gastroenterology, OHSU, and Dr. John Hunter, Chairman, Department of Surgery, OHSU. Dr. Jeffrey Peters from the University of Southern California will serve as an off-site mentor and committee member. The proposed research focuses on improving risk stratification for esophageal adenocarcinoma. The fact that most patients are unaware of the presence of Barrett's esophagus prior to cancer diagnosis and because a large proportion of these patients never develop heartburn or reflux, suggests that the current GERD symptom-based screening paradigm may be inadequate. We theorize that patients with extraesophageal reflux symptoms are at risk for unrecognized esophageal injury and thus Barrett's esophagus. We hypothesize that endoscopic screening of patients with extraesophageal reflux symptoms will reveal a significantly higher prevalence of Barrett's esophagus when compared to patients without symptoms of gastroesophageal reflux. The primary aim is to establish that patients with extraesophageal reflux symptoms who are referred to an otolaryngology clinic have a prevalence of Barrett's metaplasia equivalent to that of a population with GERD symptoms. A secondary aim is to establish that in-office unsedated small-caliber endoscopy is accurate and acceptable to patients when employed within a screening program for Barrett's esophagus.

描述（由申请人提供）： 本申请提出了一个培训计划，以发展布莱尔A。Jobe，MD成为一名独立的临床医生，科学家，专门从事巴雷特食管和食管癌的调查。Jobe博士是一名经过委员会认证的普通外科医生，接受过腹腔镜和食管手术的专科培训。指导的职业发展计划包括三个层次的方法：教学教育导致临床研究硕士学位，基础广泛的体验式学习计划和指导的临床研究经验。该计划的主要目标是让Jobe博士在各个方面都能独立地作为临床研究者。Jobe博士目前就读于俄勒冈州健康与科学大学（OHSU）的人类调查项目。这是一个为期两年的K30（NIH）赞助的项目，旨在培养以患者为导向的研究技能。指导研究将在导师委员会的指导下进行，导师委员会由OHSU医学信息学和成果研究教授Cynthia Morris博士、OHSU胃肠病学系主任大卫利伯曼博士和OHSU外科系主任John Hunter博士组成。来自南加州大学的杰弗里·彼得斯博士将担任场外导师和委员会成员。拟议的研究重点是改善食管腺癌的危险分层。事实上，大多数患者在癌症诊断之前并不知道巴雷特食管的存在，并且因为这些患者中的很大一部分从未发生胃灼热或反流，这表明目前基于GERD的筛查范式可能是不够的。我们推测，有食管外反流症状的患者有发生未被识别的食管损伤的风险，因此有发生巴雷特食管的风险。我们假设，与没有胃食管反流症状的患者相比，对有食管外反流症状的患者进行内镜筛查，会发现Barrett食管的患病率显著较高。主要目的是确定有食管外反流症状的患者转诊至耳鼻喉科诊所，其Barrett化生的患病率与有GERD症状的人群相当。第二个目的是确定在Barrett食管筛查项目中使用的门诊非镇静小口径内镜检查是准确的，并且患者可以接受。