Table 1:

Appropriate statements determined using the RAND/University of California, Los Angeles Appropriateness Method with median score, and number of experts in each category range

Consensus Statements	Median Score	# of Experts 1-3 Range (Inappropriate) (n, %)	# of Experts 4-6 Range (Uncertain) (n, %)	# of Experts 7-9 Range (Appropriate) (n, %)	MAD-M Score
Terminology and Definitions
1) Post-endoscopy esophageal neoplasia (PEEN) is the preferred term for high-grade dysplasia (HGD) or esophageal adenocarcinoma (EAC) detected before the next recommended surveillance endoscopy in a patient with non-dysplastic Barrett’s esophagus (NDBE)	8	1 (4)	2 (8)	22 (88)	1.1
2) Post-endoscopy esophageal adenocarcinoma (PEEC) is the preferred term for esophageal adenocarcinoma (EAC) detected before the next recommended surveillance endoscopy in a patient with NDBE	8	3 (12)	2 (8)	20 (80)	1.3
3) The time interval for which the occurrence of PEEN/PEEC applies is between 6 months and 3 years following screening or surveillance endoscopy	7	1 (4)	7 (28)	17 (68)	1.2
Potential Explanations
4) The potential explanations for PEEN/PEEC include missed HGD/EAC and rapidly progressive EAC	8	1 (4)	2 (8)	22 (88)	0.9
Quality Review of PEEN/PEEC cases
5) Endoscopy practices can consider reviewing PEEN/PEEC cases to understand contributing factors and areas of improvement	8	0 (0)	2 (8)	23 (92)	1
6) To facilitate the use of a common language when categorizing PEEN/PEEC cases according to their most plausible explanations, we suggest the following categories be used: a. Possible missed visible lesion, prior examination adequate b. Possible missed visible lesion, prior examination inadequate c. Detected visible lesion, no or inadequate sampling with targeted biopsies d. Detected visible lesion, incomplete resection of previously identified lesion e. Prior examination adequate and clinically indicated follow-up not recommended f. Prior examination inadequate and clinically indicated follow-up not recommended g. Prior examination adequate and failure of patient to follow-up on a recommended surveillance endoscopy interval.	7	1 (4)	3 (12)	21 (84)	1
Best Practice Advice to Reduce PEEN/PEEC
7) Endoscopists should define the extent of BE using a standardized grading system documenting the circumferential and maximal extent of the columnar lined esophagus (Prague classification) with a clear description of landmarks and characteristics of visible lesions, when present	8	0 (0)	1 (4)	24 (96)	0.6
8) Screening and surveillance endoscopy for BE should be performed using high-definition white light endoscopy (HD-WLE) and chromoendoscopy (traditional or virtual)	8	0 (0)	2 (8)	23 (92)	0.7
9) Endoscopists should spend adequate time inspecting the BE segment	9	0 (0)	0 (0)	25 (100)	0.4
10) In patients undergoing screening or surveillance endoscopy for BE, endoscopists should obtain biopsies using the Seattle biopsy protocol (4-quadrant biopsies at least every 2 cm and additional targeted biopsies or resection or outlining a plan for resection for any visible lesions)	8	0 (0)	1 (4)	24 (96)	0.6