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L'oesophage de Barrett (métaplasie intestinale de l'oesophage distal avec des cellules...

Vue déterministe de l'entité source de la LJAM. L'autorité clinique demeure avec les ID de la source cités et l'état d'approbation de l ́examinateur.

IDRF-BARRETTS-ESOPHAGUS-PREVENTION
TypeSignal d’alerte
Étatreviewed 2026-05-18 | pending_clinical_signoff
MaladiesDIS-ESOPHAGEAL
SourcesSRC-ESMO-ESOPHAGEAL-2024 SRC-NCCN-ESOPHAGEAL-2025

Origine du drapeau rouge

DéfinitionBarrett's esophagus (intestinal metaplasia of the distal esophagus with goblet cells on biopsy after EGD performed for chronic GERD or Barrett's-specific surveillance) in an individual without a current esophageal adenocarcinoma diagnosis. Established precursor lesion to esophageal adenocarcinoma — annual progression rates: non-dysplastic Barrett's ~0.1-0.3%/year to EAC, low-grade dysplasia (LGD) ~0.7-2%/year, high-grade dysplasia (HGD) ~7-19%/year. Endoscopic surveillance and endoscopic eradication therapy (radiofrequency ablation, endoscopic mucosal resection) for dysplastic Barrett's substantially reduce EAC incidence and mortality. Prevention-persona RedFlag (§20 ratification 2026-05-18, v0.3 chronic-condition pilot).
Direction cliniqueenquêter
Catégorieautres

Logique de déclenchement

{
  "any_of": [
    {
      "finding": "barretts_esophagus_diagnosis_confirmed",
      "value": true
    },
    {
      "finding": "barretts_esophagus_with_dysplasia_low_grade",
      "value": true
    },
    {
      "finding": "barretts_esophagus_with_dysplasia_high_grade",
      "value": true
    }
  ],
  "type": "lab_value"
}

Notes

v0.3 chronic-condition prevention pilot — Barrett's esophagus. Prevention-persona RedFlag (CHARTER §3 amended 2026-05-18 Path A, HCP-mediated). Fires when patient profile shows confirmed Barrett's esophagus (with or without dysplasia) AND no confirmed esophageal adenocarcinoma. Engine routes such patients to a PreventionPlan with 2 tracks: intensified EGD surveillance per ACG/NCCN cadences (IND-BARRETTS-ESOPHAGUS-PREVENTION-SURVEILLANCE) as the standard pathway; routine q5y EGD observation (IND-BARRETTS-ESOPHAGUS- PREVENTION-OBSERVATION) as the alternative — appropriate ONLY for confirmed non-dysplastic Barrett, not for any dysplasia grade. Evidence for surveillance + endoscopic eradication therapy reducing EAC incidence: HGD ablation reduces progression to EAC by ~75% vs observation (Shaheen et al. JAMA 2014; AIM-Dysplasia trial). LGD ablation reduces progression to HGD/EAC by ~75% (SURF trial, Phoa et al. JAMA 2014). For non-dysplastic Barrett, surveillance does not reduce incidence but improves earliest-stage detection. Dysplasia management: LGD → endoscopic eradication therapy (RFA ± EMR for visible lesions) OR intensified surveillance q6-12mo if patient declines. HGD → endosc...

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Indication

Signal d’alerte