How do gastroenterologists assess overall activity of eosinophilic esophagitis in adult patients?

International EEsAI Study Group

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)402-414
Number of pages13
JournalAmerican Journal of Gastroenterology
Volume110
Issue number3
DOIs
StatePublished - Mar 1 2015

Fingerprint

Eosinophilic Esophagitis
Gastroenterologists
Digestive System Endoscopy
Physicians
Linear Models
Analysis of Variance
Hypersensitivity
Regression Analysis

ASJC Scopus subject areas

  • Medicine(all)

Cite this

How do gastroenterologists assess overall activity of eosinophilic esophagitis in adult patients? / International EEsAI Study Group.

In: American Journal of Gastroenterology, Vol. 110, No. 3, 01.03.2015, p. 402-414.

Research output: Contribution to journalArticle

@article{9f1107305dc449a1aa473e651466d4b2,
title = "How do gastroenterologists assess overall activity of eosinophilic esophagitis in adult patients?",
abstract = "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.",
author = "{International EEsAI Study Group} and Schoepfer, {Alain M.} and Radoslaw Panczak and Marcel Zwahlen and Kuehni, {Claudia E.} and Michael Coslovsky and Elisabeth Maurer and Haas, {Nadine A.} and Alexander, {Jeffrey A.} and Dellon, {Evan S.} and Nirmala Gonsalves and Ikuo Hirano and John Leung and Christian Bussmann and Collins, {Margaret H.} and Newbury, {Robert O.} and {De Petris}, Giovanni and Smyrk, {Thomas C.} and Woosley, {John T.} and Pu Yan and Yang, {Guang Yu} and Yvonne Romero and Katzka, {David A.} and Furuta, {Glenn T.} and Sandeep Gupta and Aceves, {Seema S.} and Mirna Chehade and Carine Blanchard and Alex Straumann and Ekaterina Safroneeva",
year = "2015",
month = "3",
day = "1",
doi = "10.1038/ajg.2015.32",
language = "English",
volume = "110",
pages = "402--414",
journal = "American Journal of Gastroenterology",
issn = "0002-9270",
publisher = "Nature Publishing Group",
number = "3",

}

TY - JOUR

T1 - How do gastroenterologists assess overall activity of eosinophilic esophagitis in adult patients?

AU - International EEsAI Study Group

AU - Schoepfer, Alain M.

AU - Panczak, Radoslaw

AU - Zwahlen, Marcel

AU - Kuehni, Claudia E.

AU - Coslovsky, Michael

AU - Maurer, Elisabeth

AU - Haas, Nadine A.

AU - Alexander, Jeffrey A.

AU - Dellon, Evan S.

AU - Gonsalves, Nirmala

AU - Hirano, Ikuo

AU - Leung, John

AU - Bussmann, Christian

AU - Collins, Margaret H.

AU - Newbury, Robert O.

AU - De Petris, Giovanni

AU - Smyrk, Thomas C.

AU - Woosley, John T.

AU - Yan, Pu

AU - Yang, Guang Yu

AU - Romero, Yvonne

AU - Katzka, David A.

AU - Furuta, Glenn T.

AU - Gupta, Sandeep

AU - Aceves, Seema S.

AU - Chehade, Mirna

AU - Blanchard, Carine

AU - Straumann, Alex

AU - Safroneeva, Ekaterina

PY - 2015/3/1

Y1 - 2015/3/1

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=84929031752&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84929031752&partnerID=8YFLogxK

U2 - 10.1038/ajg.2015.32

DO - 10.1038/ajg.2015.32

M3 - Article

VL - 110

SP - 402

EP - 414

JO - American Journal of Gastroenterology

JF - American Journal of Gastroenterology

SN - 0002-9270

IS - 3

ER -