Quality indicators for the management of Barrett's esophagus, dysplasia, and esophageal adenocarcinoma: international consensus recommendations from the American Gastroenterological Association Symposium

Abstract

The development of and adherence to quality indicators in gastroenterology, as in all of medicine, is increasing in importance to ensure that patients receive consistent high-quality care. In addition, government-based and private insurers will be expecting documentation of the parameters by which we measure quality, which will likely affect reimbursements. Barrett's esophagus remains a particularly important disease entity for which we should maintain up-to-date guidelines, given its commonality, potentially lethal outcomes, and controversies regarding screening and surveillance. To achieve this goal, a relatively large group of international experts was assembled and, using the modified Delphi method, evaluated the validity of multiple candidate quality indicators for the diagnosis and management of Barrett's esophagus. Several candidate quality indicators achieved >80% agreement. These statements are intended to serve as a consensus on candidate quality indicators for those who treat patients with Barrett's esophagus.

Keywords: Barrett’s Esophagus; Barrett’s Surveillance; Consensus Statements; Endoscopic Mucosal Resection; Esophageal Adenocarcinoma; Gastroesophageal Reflux Disease; High-Grade Dysplasia; Low-Grade Dysplasia; Metastatic Esophageal Adenocarcinoma; Prague Criteria; Proton Pump Inhibitors; Quality Indicators; Radiofrequency Ablation.