Acceptability and accuracy of a non-endoscopic screening test for Barrett's oesophagus in primary care: cohort study.

Abstract:

OBJECTIVES:To determine the accuracy and acceptability to patients of non-endoscopic screening for Barrett's oesophagus, using an ingestible oesophageal sampling device (Cytosponge) coupled with immunocytochemisty for trefoil factor 3. DESIGN:Prospective cohort study. SETTING:12 UK general practices, with gastroscopies carried out in one hospital endoscopy unit. PARTICIPANTS:504 of 2696 eligible patients (18.7%) aged 50 to 70 years with a previous prescription for an acid suppressant (H(2) receptor antagonist or proton pump inhibitor) for more than three months in the past five years. MAIN OUTCOME MEASURES:Sensitivity and specificity estimates for detecting Barrett's oesophagus compared with gastroscopy as the ideal method, and patient anxiety (short form Spielberger state trait anxiety inventory, impact of events scale) and acceptability (visual analogue scale) of the test. RESULTS:501 of 504 (99%) participants (median age 62, male to female ratio 1:1.2) successfully swallowed the Cytosponge. No serious adverse events occurred. In total, 3.0% (15/501) had an endoscopic diagnosis of Barrett's oesophagus (≥1 cm circumferential length, median circumferential and maximal length of 2 cm and 5 cm, respectively) with intestinal metaplasia. Compared with gastroscopy the sensitivity and specificity of the test was 73.3% (95% confidence interval 44.9% to 92.2%) and 93.8% (91.3% to 95.8%) for 1 cm or more circumferential length and 90.0% (55.5% to 99.7%) and 93.5% (90.9% to 95.5%) for clinically relevant segments of 2 cm or more. Most participants (355/496, 82%, 95% confidence interval 78.9% to 85.1%) reported low levels of anxiety before the test, and scores remained within normal limits at follow-up. Less than 4.5% (2.8% to 6.1%) of participants reported psychological distress a week after the procedure. CONCLUSIONS:The performance of the Cytosponge test was promising and the procedure was well tolerated. These data bring screening for Barrett's oesophagus into the realm of possibility. Further evaluation is recommended.

journal_name

BMJ

authors

Kadri SR,Lao-Sirieix P,O'Donovan M,Debiram I,Das M,Blazeby JM,Emery J,Boussioutas A,Morris H,Walter FM,Pharoah P,Hardwick RH,Fitzgerald RC

doi

10.1136/bmj.c4372

subject

Has Abstract

pub_date

2010-09-10 00:00:00

pages

c4372

eissn

0959-8138

issn

1756-1833

journal_volume

341

pub_type

杂志文章,多中心研究
  • Trends and comparison of female first authorship in high impact medical journals: observational study (1994-2014).

    abstract:OBJECTIVE:To examine changes in representation of women among first authors of original research published in high impact general medical journals from 1994 to 2014 and investigate differences between journals. DESIGN:Observational study. STUDY SAMPLE:All original research articles published in Annals of Internal Med...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.i847

    authors: Filardo G,da Graca B,Sass DM,Pollock BD,Smith EB,Martinez MA

    更新日期:2016-03-02 00:00:00

  • Perinatal mortality and severe morbidity in low and high risk term pregnancies in the Netherlands: prospective cohort study.

    abstract:OBJECTIVE:To compare incidences of perinatal mortality and severe perinatal morbidity between low risk term pregnancies supervised in primary care by a midwife and high risk pregnancies supervised in secondary care by an obstetrician. DESIGN:Prospective cohort study using aggregated data from a national perinatal regi...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.c5639

    authors: Evers AC,Brouwers HA,Hukkelhoven CW,Nikkels PG,Boon J,van Egmond-Linden A,Hillegersberg J,Snuif YS,Sterken-Hooisma S,Bruinse HW,Kwee A

    更新日期:2010-11-02 00:00:00

  • Prospective cohort study of retinal vessel diameters and risk of hypertension.

    abstract:OBJECTIVE:To examine the relation between diameters of the retinal arterioles and 10 year incidence of hypertension. DESIGN:Population based prospective cohort study. SETTING:Beaver Dam eye study. PARTICIPANTS:2451 normotensive people aged 43 to 84 years. MAIN OUTCOME MEASURES:Diameters of retinal arterioles and ve...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.38124.682523.55

    authors: Wong TY,Shankar A,Klein R,Klein BE,Hubbard LD

    更新日期:2004-07-10 00:00:00

  • Presentation of continuous outcomes in randomised trials: an observational study.

    abstract:OBJECTIVE:To characterise the percentage of available outcome data being presented in reports of randomised clinical trials with continuous outcome measures, thereby determining the potential for incomplete reporting bias. DESIGN:Descriptive cross sectional study. DATA SOURCES:A random sample of 200 randomised trials...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.e8486

    authors: Schriger DL,Savage DF,Altman DG

    更新日期:2012-12-18 00:00:00

  • Maternal overweight and obesity in early pregnancy and risk of infant mortality: a population based cohort study in Sweden.

    abstract:OBJECTIVE:To investigate associations between maternal overweight and obesity and infant mortality outcomes, including cause-specific mortality. DESIGN:Population based cohort study. SETTING AND PARTICIPANTS:1,857,822 live single births in Sweden 1992-2010. MAIN OUTCOME MEASURES:Associations between maternal body ma...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.g6572

    authors: Johansson S,Villamor E,Altman M,Bonamy AK,Granath F,Cnattingius S

    更新日期:2014-12-02 00:00:00

  • Neonatal screening for cystic fibrosis using immunoreactive trypsinogen and direct gene analysis: four years' experience.

    abstract:OBJECTIVE:To assess the performance and impact of a two tier neonatal screening programme for cystic fibrosis based on an initial estimation of immunoreactive trypsinogen followed by direct gene analysis. DESIGN:Four year prospective study of two tier screening strategy. First tier: immunoreactive trypsinogen measured...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.308.6942.1469

    authors: Ranieri E,Lewis BD,Gerace RL,Ryall RG,Morris CP,Nelson PV,Carey WF,Robertson EF

    更新日期:1994-06-04 00:00:00

  • The accuracy of clinical symptoms and signs for the diagnosis of serious bacterial infection in young febrile children: prospective cohort study of 15 781 febrile illnesses.

    abstract:OBJECTIVES:To evaluate current processes by which young children presenting with a febrile illness but suspected of having serious bacterial infection are diagnosed and treated, and to develop and test a multivariable model to distinguish serious bacterial infections from self limiting non-bacterial illnesses. Design T...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.c1594

    authors: Craig JC,Williams GJ,Jones M,Codarini M,Macaskill P,Hayen A,Irwig L,Fitzgerald DA,Isaacs D,McCaskill M

    更新日期:2010-04-20 00:00:00

  • What do I want from health research and researchers when I am a patient?

    abstract::I have attempted to adopt the perspective of a patient--albeit one with a rather atypical background--to explore what I want from health research and researchers. This has left me with the impression that health researchers could serve the interests of the public more effectively in a variety of ways, and that they wo...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.310.6990.1315

    authors: Chalmers I

    更新日期:1995-05-20 00:00:00

  • Population based study of prevalence of islet cell autoantibodies in monozygotic and dizygotic Danish twin pairs with insulin dependent diabetes mellitus.

    abstract:OBJECTIVE:To study the comparative importance of environment and genes in the development of islet cell autoimmunity associated with insulin dependent diabetes mellitus. DESIGN:Population based study of diabetic twins. SETTING:Danish population. SUBJECTS:18 monozygotic and 36 dizygotic twin pairs with one or both pa...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.314.7094.1575

    authors: Petersen JS,Kyvik KO,Bingley PJ,Gale EA,Green A,Dyrberg T,Beck-Nielsen H

    更新日期:1997-05-31 00:00:00

  • Maternal age and fetal loss: population based register linkage study.

    abstract:OBJECTIVE:To estimate the association between maternal age and fetal death (spontaneous abortion, ectopic pregnancy, stillbirth), taking into account a woman's reproductive history. DESIGN:Prospective register linkage study. SUBJECTS:All women with a reproductive outcome (live birth, stillbirth, spontaneous abortion ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.320.7251.1708

    authors: Nybo Andersen AM,Wohlfahrt J,Christens P,Olsen J,Melbye M

    更新日期:2000-06-24 00:00:00

  • Umbilical cord clamping and preterm infants: a randomised trial.

    abstract:OBJECTIVE:To investigate the clinical effects of regulating umbilical cord clamping in preterm infants. DESIGN:A prospective randomised study. SETTING:The Queen Mother's Hospital, Glasgow. SUBJECTS:36 vaginally delivered infants over 27 and under 33 weeks' gestation. INTERVENTION:Holding the infant 20 cm below the ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1136/bmj.306.6871.172

    authors: Kinmond S,Aitchison TC,Holland BM,Jones JG,Turner TL,Wardrop CA

    更新日期:1993-01-16 00:00:00

  • Effect of high dose folic acid supplementation in pregnancy on pre-eclampsia (FACT): double blind, phase III, randomised controlled, international, multicentre trial.

    abstract:OBJECTIVE:To determine the efficacy of high dose folic acid supplementation for prevention of pre-eclampsia in women with at least one risk factor: pre-existing hypertension, prepregnancy diabetes (type 1 or 2), twin pregnancy, pre-eclampsia in a previous pregnancy, or body mass index ≥35. DESIGN:Randomised, phase III...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1136/bmj.k3478

    authors: Wen SW,White RR,Rybak N,Gaudet LM,Robson S,Hague W,Simms-Stewart D,Carroli G,Smith G,Fraser WD,Wells G,Davidge ST,Kingdom J,Coyle D,Fergusson D,Corsi DJ,Champagne J,Sabri E,Ramsay T,Mol BWJ,Oudijk MA,Walker MC,

    更新日期:2018-09-12 00:00:00

  • Uptake of systematic reviews and meta-analyses based on individual participant data in clinical practice guidelines: descriptive study.

    abstract:OBJECTIVE:To establish the extent to which systematic reviews and meta-analyses of individual participant data (IPD) are being used to inform the recommendations included in published clinical guidelines. DESIGN:Descriptive study. SETTING:Database maintained by the Cochrane IPD Meta-analysis Methods Group, supplement...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.h1088

    authors: Vale CL,Rydzewska LH,Rovers MM,Emberson JR,Gueyffier F,Stewart LA,Cochrane IPD Meta-analysis Methods Group.

    更新日期:2015-03-06 00:00:00

  • Randomised trial of personalised computer based information for cancer patients.

    abstract:OBJECTIVE:To compare the use and effect of a computer based information system for cancer patients that is personalised using each patient's medical record with a system providing only general information and with information provided in booklets. DESIGN:Randomised trial with three groups. Data collected at start of r...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1136/bmj.319.7219.1241

    authors: Jones R,Pearson J,McGregor S,Cawsey AJ,Barrett A,Craig N,Atkinson JM,Gilmour WH,McEwen J

    更新日期:1999-11-06 00:00:00

  • Effect of a late evening meal on nitrogen balance in patients with cirrhosis of the liver.

    abstract:OBJECTIVE:To assess whether a late evening meal would improve nitrogen balance in patients with cirrhosis of the liver. DESIGN:Randomised crossover study of meal schedules comparing three meals a day with four or six meals a day, the four and six meal schedules both including a late evening meal (2300). SETTING:Metab...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1136/bmj.299.6709.1202

    authors: Swart GR,Zillikens MC,van Vuure JK,van den Berg JW

    更新日期:1989-11-11 00:00:00

  • Influence of preceding length of anticoagulant treatment and initial presentation of venous thromboembolism on risk of recurrence after stopping treatment: analysis of individual participants' data from seven trials.

    abstract:OBJECTIVE:To determine how length of anticoagulation and clinical presentation of venous thromboembolism influence the risk of recurrence after anticoagulant treatment is stopped and to identify the shortest length of anticoagulation that reduces the risk of recurrence to its lowest level. DESIGN:Pooled analysis of in...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,meta分析

    doi:10.1136/bmj.d3036

    authors: Boutitie F,Pinede L,Schulman S,Agnelli G,Raskob G,Julian J,Hirsh J,Kearon C

    更新日期:2011-05-24 00:00:00

  • Risk of suicide after suicide attempt according to coexisting psychiatric disorder: Swedish cohort study with long term follow-up.

    abstract:OBJECTIVE:To investigate the impact of coexistent psychiatric morbidity on risk of suicide after a suicide attempt. DESIGN:Cohort study with follow-up for 21-31 years. SETTING:Swedish national register based study. PARTICIPANTS:39 685 people (53% women) admitted to hospital for attempted suicide during 1973-82. MAI...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.a2205

    authors: Tidemalm D,Långström N,Lichtenstein P,Runeson B

    更新日期:2008-11-18 00:00:00

  • Using care bundles to reduce in-hospital mortality: quantitative survey.

    abstract:PROBLEM:To reduce hospital inpatient mortality and thus increase public confidence in the quality of patient care in an urban acute hospital trust after adverse media coverage. DESIGN:Eight care bundles of treatments known to be effective in reducing in-hospital mortality were used in the intervention year; adjusted m...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.c1234

    authors: Robb E,Jarman B,Suntharalingam G,Higgens C,Tennant R,Elcock K

    更新日期:2010-03-31 00:00:00

  • Cardiac rehabilitation for heart failure can improve quality of life and fitness.

    abstract::The studyTaylor RS, Walker S, Ciani O, et al. Exercise-based cardiac rehabilitation for chronic heart failure: the EXTRAMATCH II individual participant data meta-analysis. Health Technol Assess 2019;23:1-98.This project was funded by the NIHR Health Technology Assessment Programme (project number 15/80/30).To read the...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 评论,杂志文章

    doi:10.1136/bmj.l5456

    authors: Cook R,Davidson P,Martin R,NIHR Dissemination Centre.

    更新日期:2019-10-01 00:00:00

  • Intravenous methylprednisolone in the treatment of Graves' ophthalmopathy.

    abstract::Eleven euthyroid patients with severe Graves' eye disease were treated with intravenous methylprednisolone and followed up for six months or more by ophthalmological assessment, orbital computed tomography (CT), photographs, and antibody measurements. Papilloedema resolved in the single patient in whom it was present;...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.297.6663.1574

    authors: Kendall-Taylor P,Crombie AL,Stephenson AM,Hardwick M,Hall K

    更新日期:1988-12-17 00:00:00

  • Low dose oestrogen combined oral contraception and risk of pulmonary embolism, stroke, and myocardial infarction in five million French women: cohort study.

    abstract:OBJECTIVE:To assess the risk of pulmonary embolism, ischaemic stroke, and myocardial infarction associated with combined oral contraceptives according to dose of oestrogen (ethinylestradiol) and progestogen. DESIGN:Observational cohort study. SETTING:Data from the French national health insurance database linked with...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 评论,杂志文章

    doi:10.1136/bmj.i2002

    authors: Weill A,Dalichampt M,Raguideau F,Ricordeau P,Blotière PO,Rudant J,Alla F,Zureik M

    更新日期:2016-05-10 00:00:00

  • Changing to generic formulary: how one fundholding practice reduced prescribing costs.

    abstract:OBJECTIVES:To observe one general practice's attempt to reduce prescribing costs on becoming third wave fundholders through the introduction of a generic formulary applied to all new and repeat prescribing. To assess the impact on patients and prescribing patterns. DESIGN:An observational study using interviews with p...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.310.6978.505

    authors: Dowell JS,Snadden D,Dunbar JA

    更新日期:1995-02-25 00:00:00

  • Immune response to a new hepatitis B vaccine in healthcare workers who had not responded to standard vaccine: randomised double blind dose-response study.

    abstract:OBJECTIVE:To evaluate the immunogenicity and reactogenicity of a new triple S recombinant hepatitis B vaccine in a cohort of healthy people in whom currently licensed hepatitis B vaccines had persistently not induced an immune response. DESIGN:Single centre, randomised, double blind, dose-response study. SETTING:Rese...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1136/bmj.314.7077.329

    authors: Zuckerman JN,Sabin C,Craig FM,Williams A,Zuckerman AJ

    更新日期:1997-02-01 00:00:00

  • Safety and effectiveness of first line eflornithine for Trypanosoma brucei gambiense sleeping sickness in Sudan: cohort study.

    abstract:OBJECTIVE:To assess the safety and effectiveness of eflornithine as first line treatment for human African trypanosomiasis. DESIGN:Cohort study. SETTING:Control programme in Ibba, southern Sudan. PARTICIPANTS:1055 adults and children newly diagnosed with second stage disease in a 16 month period. MAIN OUTCOME MEASU...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.39485.592674.BE

    authors: Priotto G,Pinoges L,Fursa IB,Burke B,Nicolay N,Grillet G,Hewison C,Balasegaram M

    更新日期:2008-03-29 00:00:00

  • Role of molecular cell biology in understanding disease.

    abstract::Molecular techniques have revolutionised our knowledge of cell and tissue function in both health and disease. We already have new and powerful treatments based on an understanding of communication between cells by messenger molecules called cytokines. Furthermore, there is great therapeutic promise in defining molecu...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,评审

    doi:10.1136/bmj.314.7075.203

    authors: Savill J

    更新日期:1997-01-18 00:00:00

  • Multiple component patient safety intervention in English hospitals: controlled evaluation of second phase.

    abstract:OBJECTIVE:To independently evaluate the impact of the second phase of the Health Foundation's Safer Patients Initiative (SPI2) on a range of patient safety measures. Design A controlled before and after design. Five substudies: survey of staff attitudes; review of case notes from high risk (respiratory) patients in med...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.d199

    authors: Benning A,Dixon-Woods M,Nwulu U,Ghaleb M,Dawson J,Barber N,Franklin BD,Girling A,Hemming K,Carmalt M,Rudge G,Naicker T,Kotecha A,Derrington MC,Lilford R

    更新日期:2011-02-03 00:00:00

  • Other cities, same problems.

    abstract::London's health care problems, particularly underfunding, are mirrored in other major cities in the United Kingdom and abroad. None has found the perfect solution, but the debates on the Tomlinson report provide an opportunity to review how to manage the three major areas of service provision, medical education, and r...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.306.6871.199

    authors: Maxwell R

    更新日期:1993-01-16 00:00:00

  • Frankincense: systematic review.

    abstract:OBJECTIVE:To assess evidence from randomised clinical trials about the effectiveness of extracts of Boswellia serrata (frankincense). DESIGN:Systematic review. DATA SOURCES:Electronic searches on Medline, Embase, Cinahl, Amed, and Cochrane Library. Hand searches of conference proceedings, bibliographies, and departme...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,评审

    doi:10.1136/bmj.a2813

    authors: Ernst E

    更新日期:2008-12-17 00:00:00

  • Prediction model to estimate presence of coronary artery disease: retrospective pooled analysis of existing cohorts.

    abstract:OBJECTIVES:To develop prediction models that better estimate the pretest probability of coronary artery disease in low prevalence populations. DESIGN:Retrospective pooled analysis of individual patient data. SETTING:18 hospitals in Europe and the United States. PARTICIPANTS:Patients with stable chest pain without ev...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,meta分析

    doi:10.1136/bmj.e3485

    authors: Genders TS,Steyerberg EW,Hunink MG,Nieman K,Galema TW,Mollet NR,de Feyter PJ,Krestin GP,Alkadhi H,Leschka S,Desbiolles L,Meijs MF,Cramer MJ,Knuuti J,Kajander S,Bogaert J,Goetschalckx K,Cademartiri F,Maffei E,Martini

    更新日期:2012-06-12 00:00:00

  • Cost effectiveness of magnetic resonance imaging in the neurosciences.

    abstract:OBJECTIVES:To measure, in a service setting, the effect of magnetic resonance imaging on diagnosis, diagnostic certainty, and patient management in the neurosciences; to measure the cost per patient scanned; to estimate the marginal cost of imaging and compare this with its diagnostic impact; to measure changes in pati...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.303.6815.1435

    authors: Szczepura AK,Fletcher J,Fitz-Patrick JD

    更新日期:1991-12-07 00:00:00