A252 IMPROVED QUALITY OF LIFE AFTER ENDOSCOPIC THERAPY FOR BARRETT’S ESOPHAGUS: A CANADIAN EXPERIENCE (2010–2016).
Bibliographic record
Abstract
Radiofrequency ablation (RFA) and endoscopic mucosal resection (EMR) are safe and effective modalities to eradicate Barrett’s esophagus (BE). There is limited Canadian data as to the value of these endoscopic therapies particularly the impact on patient quality life (QoL). To determine the efficacy of RFA +/- EMR therapy for BE in the Calgary Zone including QoL impact. A retrospective review was completed of a prospectively maintained database of patients who underwent endoscopic therapy of BE in the Calgary Zone from June 2010-August 2016. Treatment response was evaluated primarily as complete remission of dysplasia (CRD =absence of dysplasia on 2nd surveillance endoscopy post-treatment) and complete remission of intestinal metaplasia (CRIM =absence of BE on 2nd surveillance endoscopy post-treatment). Since 2014, all patients who received endoscopic therapy were invited to complete QoL questionnaires at each visit. QoL responses from baseline and 9–15 months later were analysed. Forty-two patients (95% male, mean age=67) with a mean BE length of 6.4cm completed endoscopic therapy. In those with high-grade dysplasia or intramucosal cancer (n=20), 18 had CRD (90%) and 15 achieved CRIM (75%) after a mean 3.2 RFA sessions (range 1–6). For low-grade dysplasia (n=15), 14 patients (93%) had CRD and 11 (73%) achieved CRIM after a mean 3.4 RFA sessions (range 1–8). In non-dysplastic BE (n=7), 6 (86%) achieved CRIM after a mean 4.7 RFA sessions (range 3–7). Overall, 15 (36%) patients had EMR during the course of treatment. Four patients (9%) developed a symptomatic stricture as a result of treatment. In the QoL survey (Table 1), after endoscopic treatment of BE, patients had significantly reduced worry about esophagectomy (p=0.01) and less stress due to their esophageal condition (p=0.03). There was also a trend toward decreased disease worry (p=0.14). In Calgary, endoscopic therapy was safe and highly effective in achieving CRD and CRIM. Impact of these treatments on QoL is also significant, as patients progressively had less worry about esophagectomy and associated stress. Further prospective data is needed to confirm this response is sustained. QoL responses in patients who completed Barrett’s endotherapy (n=18). QoL responses are expressed as median (interquartile range). None
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".