Diagnostic inconsistencies in XXXX . Department of Veterans Affairs Gastroesophageal Reflux Study Group.

@entity1 @entity354 @entity355
BACKGROUND/AIMS: Few studies have compared the precision of various diagnostic tests used to determine the presence of @entity355 . The aim of this study was to compare the results of histological, endoscopic, and manometric tests for @entity1 with @entity355 in two closely spaced examinations. METHODS: In a Veterans Administration Cooperative Study, 192 @entity1 with complicated @entity354 had esophageal manometry and endoscopy performed at baseline and after 6 weeks. At each examination, the endoscopist localized the most proximal level of Barrett's epithelium and the lower esophageal sphincter and obtained esophageal biopsy specimens. RESULTS: One hundred sixteen @entity1 met the criteria for @entity355 on at least one of the two endoscopic examinations. Among @entity1 with specialized columnar epithelium, 20% had specialized columnar epithelium found on only one of the two examinations. Although the mean lower esophageal sphincter level did not change, approximately 10% of @entity1 had a change > or = 4 cm on endoscopy and manometry between examinations. This led to an apparent change in the diagnosis in 18% of @entity1 with @entity355 . CONCLUSIONS: From one endoscopic examination to another, inconsistencies in the ability to detect specialized columnar epithelium are common. This may lead to substantial problems in establishing an accurate diagnosis of @entity355 .
