A clinical risk prediction model for Barrett esophagus

Thrift, Aaron P., Kendall, Bradley J., Pandeya, Nirmala, Vaughan, Thomas L. and Whiteman, David C. (2012) A clinical risk prediction model for Barrett esophagus. Cancer Prevention Research, 5 9: 1115-1123. doi:10.1158/1940-6207.CAPR-12-0010

Author Thrift, Aaron P.
Kendall, Bradley J.
Pandeya, Nirmala
Vaughan, Thomas L.
Whiteman, David C.
Title A clinical risk prediction model for Barrett esophagus
Journal name Cancer Prevention Research   Check publisher's open access policy
ISSN 1940-6207
Publication date 2012-09-01
Sub-type Article (original research)
DOI 10.1158/1940-6207.CAPR-12-0010
Open Access Status Not Open Access
Volume 5
Issue 9
Start page 1115
End page 1123
Total pages 9
Place of publication Philadelphia, PA, United States
Publisher American Association for Cancer Research
Language eng
Formatted abstract
Barrett esophagus is the only known precursor to esophageal adenocarcinoma. As definitive diagnosis requires costly endoscopic investigation, we sought to develop a risk prediction model to aid in deciding which patients with gastroesophageal reflux symptoms to refer for endoscopic screening for Barrett esophagus. The study included data from patients with incident nondysplastic Barrett esophagus (n = 285) and endoscopy control patients with esophageal inflammatory changes without Barrett esophagus ("inflammation controls", n = 313). We used two phases of stepwise backwards logistic regression to identify the important predictors for Barrett esophagus in men and women separately: first, including all significant covariates from univariate analyses and then fitting non-significant covariates from univariate analyses to identify those effects detectable only after adjusting for other factors. The final model pooled these predictors and was externally validated for discrimination and calibration using data from a Barrett esophagus study conducted in western Washington State. The final risk model included terms for age, sex, smoking status, body mass index, highest level of education, and frequency of use of acid suppressant medications (area under the ROC curve, 0.70; 95%CI, 0.66-0.74). The model had moderate discrimination in the external dataset (area under the ROC curve, 0.61; 95%CI, 0.56-0.66). The model was well calibrated (Hosmer-Lemeshow test, P=0.75), with predicted probability and observed risk highly correlated. The prediction model performed reasonably well and has the potential to be an effective and useful clinical tool in selecting patients with gastroesophageal reflux symptoms to refer for endoscopic screening for Barrett esophagus.
Keyword Projecting Individualized Probabilities
Lung Cancer Risk
Breast Cancer
Gastroesophageal Reflux
Task Force
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Public Health Publications
School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 27 times in Thomson Reuters Web of Science Article | Citations
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Created: Sat, 05 Jan 2013, 00:33:23 EST by Geraldine Fitzgerald on behalf of School of Public Health