How Do Gastroenterologists Assess Overall Activity of Eosinophilic Esophagitis in Adult Patients?

Schöpfer, Alain; Panczak, Radoslaw; Zwahlen, Marcel; Kuehni, Claudia E; Coslovsky, Michael; Maurer, Elisabeth; Haas, Nadine A; Alexander, Jeffrey A; Dellon, Evan S; Gonsalves, Nirmala; Hirano, Ikuo; Leung, John; Bussmann, Christian; Collins, Margaret H; Newbury, Robert O; De Petris, Giovanni; Smyrk, Thomas C; Woosley, John T; Yan, Pu; Yang, Guang-Yu; ... (2015). How Do Gastroenterologists Assess Overall Activity of Eosinophilic Esophagitis in Adult Patients? American journal of gastroenterology, 110(3), pp. 402-414. Nature 10.1038/ajg.2015.32

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OBJECTIVES:There is no "gold standard" for assessing disease activity in patients with eosinophilic esophagitis (EoE). We aimed to compare physicians' judgment of EoE activity with patients' judgment of symptom severity. We also aimed to examine the relative contribution of symptoms as well as endoscopic and histologic findings in shaping physicians' judgment of EoE activity.METHODS:Six gastroenterologists (all EoE experts) assessed EoE-associated symptoms in adult patients. Patients completed a symptom instrument and provided global assessment of EoE symptom severity (PatGA) (Likert scale: 0 (inactive) to 10 (most active)). Following esophagogastroduodenoscopy with biopsy sampling, gastroenterologists provided a global assessment of EoE activity (PhysGA) (Likert scale from 0 to 10) based on patient history and endoscopic and histologic findings. Linear regression and analysis of variance was used to quantify the extent to which variations in severity of EoE symptoms and endoscopic and histologic findings explain variations in PhysGA.RESULTS:A total of 149 EoE patients were prospectively included (71.8% male, median age at inclusion 38 years, 71.8% with concomitant allergies). A moderate positive correlation between PhysGA and PatGA (rho=0.442, P<0.001) was observed and the mean difference in the Bland-Altman plot was 1.77. Variations in severity of endoscopic findings, symptoms, and histologic findings alone explained 53%, 49%, and 30%, of the variability in PhysGA, respectively. Together, these findings explained 75% of variability in PhysGA.CONCLUSIONS:Gastroenterologists rate EoE activity mainly on the basis of endoscopic findings and symptoms and, to a lesser extent, on histologic findings.Am J Gastroenterol advance online publication, 3 March 2015; doi:10.1038/ajg.2015.32.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Gastroenterology
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine
04 Faculty of Medicine > Pre-clinic Human Medicine > CTU Bern

UniBE Contributor:

Schöpfer, Alain; Panczak, Radoslaw; Zwahlen, Marcel; Kühni, Claudia; Coslovsky, Michael; Maurer, Elisabeth; Haas, Nadine and Safroneeva, Ekaterina

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0002-9270

Publisher:

Nature

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

13 Mar 2015 10:09

Last Modified:

15 May 2016 12:17

Publisher DOI:

10.1038/ajg.2015.32

PubMed ID:

25732414

Additional Information:

Schoepfer and Panczak contributed equally to this work.

BORIS DOI:

10.7892/boris.64445

URI:

https://boris.unibe.ch/id/eprint/64445

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