TY - JOUR
T1 - Rio de Janeiro Global Consensus on Landmarks, Definitions, and Classifications in Barrett's Esophagus
T2 - World Endoscopy Organization Delphi Study
AU - Emura, Fabian
AU - Chandrasekar, Viveksandeep Thoguluva
AU - Hassan, Cesare
AU - Armstrong, David
AU - Messmann, Helmut
AU - Arantes, Vitor
AU - Araya, Raul
AU - Barrera-Leon, Oscar
AU - Bergman, Jacques J.G.H.M.
AU - Bandhari, Pradeep
AU - Bourke, Michael J.
AU - Cerisoli, Cecilio
AU - Chiu, Philip Wai Yan
AU - Desai, Madhav
AU - Dinis-Ribeiro, Mário
AU - Falk, Gary W.
AU - Fujishiro, Mitsuhiro
AU - Gaddam, Srinivas
AU - Goda, Kenichi
AU - Gross, Seth
AU - Haidry, Rehan
AU - Ho, Lawrence
AU - Iyer, Prasad G.
AU - Kashin, Sergey
AU - Kothari, Shivangi
AU - Lee, Yeong Yeh
AU - Matsuda, Koji
AU - Neuhaus, Horst
AU - Oyama, Tsuneo
AU - Ragunath, Krish
AU - Repici, Alessandro
AU - Shaheen, Nicholas
AU - Singh, Rajvinder
AU - Sobrino-Cossio, Sergio
AU - Wang, Kenneth K.
AU - Waxman, Irving
AU - Sharma, Prateek
N1 - Publisher Copyright:
© 2022 AGA Institute
PY - 2022/7
Y1 - 2022/7
N2 - Background & Aims: Despite the significant advances made in the diagnosis and treatment of Barrett's esophagus (BE), there is still a need for standardized definitions, appropriate recognition of endoscopic landmarks, and consistent use of classification systems. Current controversies in basic definitions of BE and the relative lack of anatomic knowledge are significant barriers to uniform documentation. We aimed to provide consensus-driven recommendations for uniform reporting and global application. Methods: The World Endoscopy Organization Barrett's Esophagus Committee appointed leaders to develop an evidence-based Delphi study. A working group of 6 members identified and formulated 23 statements, and 30 internationally recognized experts from 18 countries participated in 3 rounds of voting. We defined consensus as agreement by ≥80% of experts for each statement and used the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) tool to assess the quality of evidence and the strength of recommendations. Results: After 3 rounds of voting, experts achieved consensus on 6 endoscopic landmarks (palisade vessels, gastroesophageal junction, squamocolumnar junction, lesion location, extraluminal compressions, and quadrant orientation), 13 definitions (BE, hiatus hernia, squamous islands, columnar islands, Barrett's endoscopic therapy, endoscopic resection, endoscopic ablation, systematic inspection, complete eradication of intestinal metaplasia, complete eradication of dysplasia, residual disease, recurrent disease, and failure of endoscopic therapy), and 4 classification systems (Prague, Los Angeles, Paris, and Barrett's International NBI Group). In round 1, 18 statements (78%) reached consensus, with 12 (67%) receiving strong agreement from more than half of the experts. In round 2, 4 of the remaining statements (80%) reached consensus, with 1 statement receiving strong agreement from 50% of the experts. In the third round, a consensus was reached on the remaining statement. Conclusions: We developed evidence-based, consensus-driven statements on endoscopic landmarks, definitions, and classifications of BE. These recommendations may facilitate global uniform reporting in BE.
AB - Background & Aims: Despite the significant advances made in the diagnosis and treatment of Barrett's esophagus (BE), there is still a need for standardized definitions, appropriate recognition of endoscopic landmarks, and consistent use of classification systems. Current controversies in basic definitions of BE and the relative lack of anatomic knowledge are significant barriers to uniform documentation. We aimed to provide consensus-driven recommendations for uniform reporting and global application. Methods: The World Endoscopy Organization Barrett's Esophagus Committee appointed leaders to develop an evidence-based Delphi study. A working group of 6 members identified and formulated 23 statements, and 30 internationally recognized experts from 18 countries participated in 3 rounds of voting. We defined consensus as agreement by ≥80% of experts for each statement and used the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) tool to assess the quality of evidence and the strength of recommendations. Results: After 3 rounds of voting, experts achieved consensus on 6 endoscopic landmarks (palisade vessels, gastroesophageal junction, squamocolumnar junction, lesion location, extraluminal compressions, and quadrant orientation), 13 definitions (BE, hiatus hernia, squamous islands, columnar islands, Barrett's endoscopic therapy, endoscopic resection, endoscopic ablation, systematic inspection, complete eradication of intestinal metaplasia, complete eradication of dysplasia, residual disease, recurrent disease, and failure of endoscopic therapy), and 4 classification systems (Prague, Los Angeles, Paris, and Barrett's International NBI Group). In round 1, 18 statements (78%) reached consensus, with 12 (67%) receiving strong agreement from more than half of the experts. In round 2, 4 of the remaining statements (80%) reached consensus, with 1 statement receiving strong agreement from 50% of the experts. In the third round, a consensus was reached on the remaining statement. Conclusions: We developed evidence-based, consensus-driven statements on endoscopic landmarks, definitions, and classifications of BE. These recommendations may facilitate global uniform reporting in BE.
KW - Barrett's esophagus
KW - Classifications
KW - Definitions
KW - Delphi consensus
KW - Landmarks
KW - Reporting
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U2 - 10.1053/j.gastro.2022.03.022
DO - 10.1053/j.gastro.2022.03.022
M3 - Article
C2 - 35339464
AN - SCOPUS:85132431909
SN - 0016-5085
VL - 163
SP - 84-96.e2
JO - Gastroenterology
JF - Gastroenterology
IS - 1
ER -