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Esophagus

, Volume 16, Issue 1, pp 71–76 | Cite as

Inter-institutional variations regarding Barrett’s esophagus diagnosis

  • Norihisa IshimuraEmail author
  • Mika Yuki
  • Takafumi Yuki
  • Yoshinori Komazawa
  • Yoshinori Kushiyama
  • Hirofumi Fujishiro
  • Shunji Ishihara
  • Yoshikazu Kinoshita
Original Article
  • 43 Downloads

Abstract

Background

Barrett’s esophagus (BE) is a known precursor for development of esophageal adenocarcinoma and surveillance of affected patients is necessary when cancer progression risk is considered to be high. However, the accuracy of BE diagnosis may not be homogenous among institutions with endoscopy units. We investigated inter-institutional variability by examining the accuracy of endoscopic diagnosis of BE at 4 different hospitals.

Methods

The accuracy of BE diagnosis at the 4 hospitals was retrospectively reviewed by 6 expert endoscopists, who independently reviewed endoscopic images of approximately 500 consecutive patients examined at each hospital without information regarding the diagnosis by the on-site endoscopists. When the expert reviewers made different diagnosis, a final diagnosis was made by consensus. That was then compared with the diagnosis of the attending endoscopists at each hospital and their concordance was calculated separately for each endoscopy unit. In addition, the relationship between diagnostic accuracy and endoscopic experience was assessed.

Results

The prevalence of BE diagnosis by the on-site endoscopists was not homogenous and varied widely (17.2–96.8%). In 1 hospital, over-diagnosis was the cause of dissimilarity, while under-diagnosis was the cause in two hospitals. Diagnostic accuracy by the attending endoscopists in all 4 hospitals ranged from 44.6 to 83.1% (P < 0.05). There was no significant association between diagnostic accuracy and endoscopic experience or board licensing status of the on-site endoscopists.

Conclusion

Diagnostic accuracy for BE was not homogenous among 4 hospitals, and problems related to over- and under-diagnosis should be considered.

Keywords

Barrett’s esophagus Endoscopic diagnosis Diagnostic variation 

Notes

Acknowledgements

The authors thank Ms. Keiko Masuzaki and Ms. Rika Tohma for the excellent technical assistance.

Compliance with ethical standards

Ethical statement

The present study was performed at the Shimane University Hospital in accordance with the Declaration of Helsinki and the protocol was approved by the ethics committee of the Shimane, University School of Medicine.

Conflict of interest

The authors declare no conflict of interests for this article.

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Copyright information

© The Japan Esophageal Society and Springer Japan KK, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Gastroenterology and HepatologyShimane University School of MedicineIzumoJapan
  2. 2.Department of Internal MedicineIzumo City General Medical CenterIzumoJapan
  3. 3.Division of GastroenterologyMatsue Red Cross HospitalMatsueJapan
  4. 4.Division of GastroenterologyShimane Prefectural Central HospitalIzumoJapan

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