Table 5.
Sensitivities, specificities, positive predictive values, negative predictive values, positive likelihood ratios, negative likelihood ratios, areas under the receiver operating characteristic, and 95% confidence intervals of proposed Barrett’s esophagus (BE) screening guidelines in an unreferred primary care population.
| Screen those with frequent GERD symptoms irrespective of duration OR screen those with no GERD symptoms who have other BE risk factors* | ||||
| ≥3 risk factors | ≥4 risk factors | ≥5 risk factors | ≥6 risk factors | |
| Sensitivity (95% CI) | 100.0% (92.0%–100.0%) | 88.6% (75.4%–96.2%) | 81.8% (67.3%–91.8%) | 43.2% (28.3%–59.0%) |
| Specificity (95% CI) | 2.3% (1.2%–4.2%) | 17.1% (13.8%–20.8%) | 51.2% (46.5%–55.8%) | 72.9% (68.7%–76.9%) |
| PPV (95% CI) | 8.8% (6.4%–11.6%) | 9.1% (6.6%–12.2%) | 13.6% (9.7%–18.3%) | 13.0% (8.0%–19.6%) |
| NPV (95% CI) | 100.0% (71.5%–100.0%) | 94.1% (86.8%–98.1%) | 96.8% (93.7%–98.6%) | 93.2% (90.1%–95.5%) |
| +LR (95% CI) | 1.02 (1.01–1.04) | 1.07 (0.95–1.20) | 1.68 (1.42–1.98) | 1.59 (1.10–2.31) |
| −LR (95% CI) | 0.00 (--) | 0.67 (0.29–1.56) | 0.36 (0.19–0.67) | 0.78 (0.60–1.01) |
| AUROC (95% CI) | 0.51 (0.50–0.52) | 0.53 (0.48–0.58) | 0.66 (0.60–0.73) | 0.58 (0.50–0.66) |
| Screen those frequent GERD symptoms ≥ 5 years OR screen those with GERD symptoms <5 years who have other BE risk factors* | ||||
| ≥ 3 risk factors | ≥ 4 risk factors | ≥ 5 risk factors | ≥ 6 risk factors | |
| Sensitivity (95% CI) | 100.0% (92.0%–100.0%) | 86.4% (72.6%–94.8%) | 79.5% (64.7%–90.2%) | 40.9% (26.3%–56.8%) |
| Specificity (95% CI) | 2.3% (1.2%–4.2%) | 17.3% (14.0%–21.0%) | 51.8% (47.2%–56.4%) | 80.2% (69.3%–77.5%) |
| PPV (95% CI) | 8.8% (6.4%–11.6%) | 8.9% (6.4%–12.0%) | 13.4% (9.5%–18.2%) | 12.7% (7.7%–19.3%) |
| NPV (95% CI) | 100.0% (71.5%–100.0%) | 93.1% (85.6%–97.4%) | 96.4% (93.3%–98.4%) | 93.0% (89.9%–95.4%) |
| +LR (95% CI) | 1.02 (1.01–1.04) | 1.04 (0.92–1.18) | 1.65 (1.38–1.97) | 1.55 (1.05–2.28) |
| −LR (95% CI) | 0.00 (--) | 0.79 (0.37–1.70) | 0.39 (0.22–0.71) | 0.80 (0.62–1.03) |
| AUROC (95% CI) | 0.51 (0.50–0.52) | 0.52 (0.46–0.57) | 0.66 (0.59–0.72) | 0.57 (0.50–0.65) |
*
age ≥ 50 years, male, non-Hispanic white race, obese or high waist-to-hip ratio, current or past smoking, family history of BE or esophageal cancer
Abbreviations: CI, confidence interval; PPV, positive predictive value; NPV, negative predictive value; +LR, positive likelihood ratio; −LR, negative likelihood ratio; AUROC, area under the receiver operating characteristic.