ASGE: Electronic diagnosis provided inaccurate results for Barrett's esophagus patients

OAK BROOK, Ill. In a review of more than 2,000 patients coded for Barrett’s esophagus, electronic diagnosis overestimated the prevalence of the disease, according to researchers in California, the American Society for Gastroinestinal Endoscopy announced last week.

According to the review, researchers found that only 61.9% of patients assigned a billing diagnosis code for Barrett’s esophagus actually had Barrett’s esophagus after a manual record review.

The misdiagnosis could potentially undermine or skew future research into patients diagnosed with Barrett’s esophagus, a condition where the lining of the esophagus changes due to chronic inflammation, generally from gastroesophageal reflux disease. Definitive diagnosis requires a biopsy, taken at upper endoscopy, demonstrating replacement of the normal cell lining with one more like the cell lining of the small intestine. This is also known as intestinal metaplasia. Barrett’s esophagus itself has no specific symptoms, but this change can increase the risk of esophageal adenocarcinoma (a type of esophageal cancer).

Researchers concluded that electronic coding alone overestimates the prevalence of Barrett’s esophagus, and most clinical and research uses will require a manual verification of disease status.

The study appears in the May issue of GIE: Gastrointestinal Endoscopy, the monthly peer-reviewed scientific journal of the ASGE.