RT Journal Article
SR Electronic
T1 British Society of Gastroenterology guidelines on the diagnosis and management of Barrett's oesophagus
JF Gut
JO Gut
FD BMJ Publishing Group Ltd and British Society of Gastroenterology
SP 7
OP 42
DO 10.1136/gutjnl-2013-305372
VO 63
IS 1
A1 Rebecca C Fitzgerald
A1 Massimiliano di Pietro
A1 Krish Ragunath
A1 Yeng Ang
A1 Jin-Yong Kang
A1 Peter Watson
A1 Nigel Trudgill
A1 Praful Patel
A1 Philip V Kaye
A1 Scott Sanders
A1 Maria O'Donovan
A1 Elizabeth Bird-Lieberman
A1 Pradeep Bhandari
A1 Janusz A Jankowski
A1 Stephen Attwood
A1 Simon L Parsons
A1 Duncan Loft
A1 Jesper Lagergren
A1 Paul Moayyedi
A1 Georgios Lyratzopoulos
A1 John de Caestecker
YR 2014
UL http://gut.bmj.com/content/63/1/7.abstract
AB These guidelines provide a practical and evidence-based resource for the management of patients with Barrett's oesophagus and related early neoplasia. The Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument was followed to provide a methodological strategy for the guideline development. A systematic review of the literature was performed for English language articles published up until December 2012 in order to address controversial issues in Barrett's oesophagus including definition, screening and diagnosis, surveillance, pathological grading for dysplasia, management of dysplasia, and early cancer including training requirements. The rigour and quality of the studies was evaluated using the SIGN checklist system. Recommendations on each topic were scored by each author using a five-tier system (A+, strong agreement, to D+, strongly disagree). Statements that failed to reach substantial agreement among authors, defined as >80% agreement (A or A+), were revisited and modified until substantial agreement (>80%) was reached. In formulating these guidelines, we took into consideration benefits and risks for the population and national health system, as well as patient perspectives. For the first time, we have suggested stratification of patients according to their estimated cancer risk based on clinical and histopathological criteria. In order to improve communication between clinicians, we recommend the use of minimum datasets for reporting endoscopic and pathological findings. We advocate endoscopic therapy for high-grade dysplasia and early cancer, which should be performed in high-volume centres. We hope that these guidelines will standardise and improve management for patients with Barrett's oesophagus and related neoplasia.