TABLE 1.
Final Barrett’s esophagus assignment and reasons for exclusion on the basis of medical record review
| All, no. (%) | SNOMED | ICD | Both SNOMED and ICD | |
|---|---|---|---|---|
| Total subjects | 2470 (100.0) | 798 | 571 | 1101 |
| Barrett’s esophagus confirmed | 1530 (61.9) | 437 (54.8) | 153 (26.8) | 940 (85.4) |
| Barrett’s esophagus diagnosis not confirmed | 848 (34.3) | 330 (41.4) | 390 (68.3) | 128 (11.6) |
| Insufficient data available to classify | 92 (3.7) | 31 (3.9) | 28 (4.9) | 33 (3.0) |
| Reasons for exclusion* | ||||
| Irregular z-line only† | 88 (3.6) | 35 (1.2) | 10 (1.8) | 43 (5.4) |
| No endoscopic findings‡ | 228 (9.2) | 119 (14.9) | 39 (6.8) | 70 (6.4) |
| No intestinal metaplasia on biopsy | 214 (8.7) | 63 (7.9) | 140 (24.5) | 11 (1.0) |
| No endoscopic findings and no intestinal metaplasia | 240 (9.7) | 87 (10.9) | 147 (25.7) | 6 (0.5) |
| Possible Barrett’s esophagus, no biopsies clearly from area of interest | 37 (1.5) | 1 (0.1) | 34 (5.6) | 2 (0.2) |
| No pathology record available§ | 4 (0.2) | 1 (0.1) | 2 (0.4) | 1 (0.1) |
| No endoscopy record available§ | 12 (0.5) | 7 (0.9) | 2 (0.4) | 3 (0.3) |
| Neither endoscopy nor pathology records available§ | 18 (0.7) | 4 (0.5) | 10 (1.8) | 4 (0.4) |
| Insufficient detail§ | 70 (2.8) | 19 (2.4) | 24 (4.2) | 27 (2.5) |
| Other | 29 (1.2) | 17 (2.1) | 10 (1.8) | 2 (0.2) |
Among the 848 persons in whom a diagnosis was not confirmed.
The squamocolumnar junction (the “z-line”) was described as irregular and the report did not clearly describe substantial tongues of columnar mucosa extending proximally into the body of the esophagus.
No endoscopic findings reported that were clearly diagnostic of Barrett’s esophagus.
The reviewer assigned these reviews as partially incomplete but stated that the available data were sufficient for classification. These included persons, for example, with no record of an endoscopy being performed to support the diagnosis (and no outside records), a note of a biopsy specimen being taken but no pathologic interpretation or specimen recorded in the pathology department, clear coding errors, etc.