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News

An endoscopic grading system for Barrett's Esophagus

The Prague circumferential and maximum criteria have high overall validity for the endoscopic assessment of Barrett's esophagus lengths, reports November's Gastroenterology.

News image

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Barrett's esophagus is a premalignant condition for esophageal adenocarcinoma.

Its diagnosis relying initially on recognition of a columnar-lined distal esophagus.

Dr Prateek Sharma and colleagues from Missouri developed and validated explicit.

Consensus-driven criteria for the endoscopic diagnosis and grading of Barrett's esophagus.

An international working group agreed on criteria and developed materials for the formal evaluation.

The reliability coefficient for 1 cm Barrett's recognition was 0.7
Gastroenterology

The research team used video-endoscopic recordings gathered in a standardized manner in 29 patients.

The criteria included assessment of the circumferential and maximum extent of the endoscopically visualized Barrett's segment, and endoscopic landmarks.

The recordings were scored according to these criteria by a separate international panel of 29 endoscopists.

The Prague circumferential and maximum criteria give explicit guidance on the endoscopic recognition of Barrett's esophagus, and grading of its extent.

Reliability coefficients for the assessment of the circumferential and maximum extent of the endoscopic Barrett's segment above the gastroesophageal junction was about 0.9 for both.

The team found that the rates of exact agreement for pairwise comparisons of individual patient values were 53% and 38%, respectively.

However, the values for agreement within a 2 cm interval were 97% and 95%, respectively.

The researchers noted overall reliability coefficients for endoscopic recognition of Barrett's esophagus 1 cm or more was 0.7.

For Barrett's esophagus less than 1 cm, it was 0.2.

The reliability coefficients for recognizing the location of the gastroesophageal junction and the diaphragmatic hiatus were 0.9 and 0.8, respectively.

Dr Sharma's team comments, “The Prague circumferential and maximum criteria have high overall validity for the endoscopic assessment of visualized Barrett's esophagus lengths.”

Gastroenterol 2006: 131(5): 1392-9
16 November 2006

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