Rare Diseases Symptoms Automatic Extraction
Home
A random Abstract
Our Project
Our Team
The Impact of Uncertainty in Barrett's Esophagus Progression Rates on Hypothetical Screening and Treatment Decisions.
[esophageal adenocarcinoma]
.
Estimates
for
the
annual
progression
rate
from
Barrett
's
esophagus
(
BE
)
to
esophageal
adenocarcinoma
(
EAC
)
vary
widely
.
In
this
explorative
study
,
we
quantified
how
this
uncertainty
affects
the
estimates
of
effectiveness
and
efficiency
of
screening
and
treatment
for
EAC
.
.
We
developed
3
versions
of
the
University
of
Washington
/
Microsimulation
Screening
Analysis-
EAC
model
.
The
models
differed
with
respect
to
the
annual
progression
rate
from
BE
to
EAC
(
0
.
12
%
or
0
.
42
%
)
and
the
possibility
of
spontaneous
regression
of
dysplasia
(
yes
or
no
)
.
All
versions
of
the
model
were
calibrated
to
the
observed
Surveillance
,
Epidemiology
,
and
End
Results
esophageal
cancer
incidence
rates
from
1998
to
2009
.
To
identify
the
impact
of
natural
history
,
we
estimated
the
incidence
and
deaths
prevented
as
well
as
numbers
needed
to
screen
(
NNS
)
and
treat
(
NNT
)
of
a
one
-time
perfect
screening
at
age
65
years
that
detected
all
prevalent
BE
cases
,
followed
by
a
perfect
treatment
intervention
.
.
Assuming
a
perfect
screening
and
treatment
intervention
for
all
patients
with
BE
,
the
maximum
EAC
mortality
reduction
(
64
%
-
66
%
)
and
the
NNS
per
death
prevented
(
470
-
510
)
were
similar
across
the
3
model
versions
.
However
,
3
times
more
people
needed
to
be
treated
to
prevent
1
death
(
24
v
.
8
)
in
the
0
.
12
%
regression
model
compared
with
the
0
.
42
%
progression
model
.
Restricting
treatment
to
those
with
dysplasia
or
only
high
-grade
dysplasia
resulted
in
smaller
differences
in
NNT
(
2
-
3
to
prevent
one
EAC
case
)
but
wider
variation
in
effectiveness
(
mortality
reduction
of
15
%
-
24
%
)
.
.
The
uncertainty
in
the
natural
history
of
the
BE
to
EAC
sequence
influenced
the
estimates
of
effectiveness
and
efficiency
of
BE
screening
and
treatment
considerably
.
This
uncertainty
could
seriously
hamper
decision
making
about
implementing
BE
screening
and
treatment
interventions
.
Diseases
Validation
Diseases presenting
"spontaneous regression"
symptom
coats disease
cutaneous mastocytosis
esophageal adenocarcinoma
focal myositis
You can validate or delete this automatically detected symptom
Validate the Symptom
Delete the Symptom
