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Quality Indicators in Endoscopic Ablation for Barrett’s Esophagus

  • Samuel Han
  • Sachin WaniEmail author
Endoscopy (P Siersema, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Endoscopy

Opinion Statement

Barrett’s esophagus (BE) is a well-established premalignant condition for esophageal adenocarcinoma (EAC); a cancer that is associated with a poor 5-year survival rate. Several strategies have been explored in the context of reducing the burden of EAC. Endoscopic eradication therapy (EET) is considered the standard of care for the management of patients with BE with dysplasia and early neoplasia; a practice that has been endorsed by all gastroenterology societal guidelines. The effectiveness of EET has been demonstrated in multiple studies and contemporary management includes a combination of endoscopic mucosal resection (EMR) of all visible lesions followed by eradication of the remaining BE using ablative techniques of which radiofrequency ablation (RFA) has the best evidence supporting effectiveness and safety. These techniques are being used increasingly at academic tertiary care centers and community practices. In this era of value-based health care, there is increased focus on the establishment, documentation, and reporting of quality indicators; indicators that are important to physicians, patients, and payers. The purpose of this review is to highlight the current status of quality indicators in EET for the management of patients with BE-related neoplasia and discuss the future steps required to ensure that these quality indicators are uniformly incorporated into practice.

Keywords

Quality indicators Barrett’s esophagus Endoscopic eradication therapy Endoscopic ablation Radiofrequency ablation 

Abbreviations

BE

Barrett’s esophagus

EAC

Esophageal adenocarcinoma

EET

Endoscopic eradication therapy

EMR

Endoscopic mucosal resection

RFA

Radiofrequency ablation

LGD

Low-grade dysplasia

HGD

High grade dysplasia

GI

Gastroenterology

AGA

American Gastroenterological Association

ASGE

American Society for Gastrointestinal Endoscopy

ACG

American College of Gastroenterology

RAM

RAND/University of California, Los Angeles Appropriateness Methodology

HDWLE

High definition white light endoscopy

CE-IM

Complete eradication of intestinal metaplasia

CE-N

Complete eradication of neoplasia

Notes

Acknowledgements

This work was supported by the University of Colorado, Department of Medicine Outstanding Early Scholars Program (SW).

Compliance with Ethical Standards

Conflict of Interest

Samuel Han declares no conflict of interest.

Sachin Wani reports grants from University of Colorado, Department of Medicine Outstanding Early Scholars Program and consultancy fees from Boston Scientific and Medtronic.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References and Recommented Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.Division of Gastroenterology and HepatologyUniversity of Colorado Anschutz Medical CampusAuroraUSA

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