TY - JOUR
T1 - The adoption of ablation therapy for Barrett's esophagus
T2 - A cohort study of gastroenterologists
AU - Gross, Cary P.
AU - Cruz-Correa, Marcia
AU - Canto, Marcia Irene
AU - McNeil-Solis, Corlina
AU - Valente, Thomas W.
AU - Powe, Neil R.
N1 - Funding Information:
The authors acknowledge the support of the Robert Wood Johnson Clinical Scholars Program. N.R.P. is supported by Grant K240K02643 from the National Institute of Diabetes & Digestive & Kidney Diseases.
Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2002
Y1 - 2002
N2 - OBJECTIVES: Although ablation therapy may be useful in the treatment of Barrett's esophagus, evidence of effectiveness is scarce, and little is known about current utilization of ablation. We aimed to determine whether the use of ablation was increasing in a cohort of gastroenterologists, and to identify physician beliefs and characteristics associated with ablation use. METHODS: We surveyed a national sample of gastroenterologists about ablation use, with an 18-month follow-up. The self-administered instrument included questions about demographic characteristics, attitudes about ablation therapy, and prior experience with ablation. Case scenarios were also included. We used logistic regression to identify factors associated with the use of ablation in patients with Barrett's esophagus. RESULTS: Two hundred seventy-nine (50.3% of those eligible) responded to the baseline survey. Few agreed that ablation lowers the risk of adenocarcinoma (15%) or is supported by the medical literature (19%). However, 25% of respondents reportedly had used ablation at baseline, and this increased to 36% in the follow-up survey (p = 0.0003). The use of ablation was significantly associated with physician age greater than 54 yr (odds ratio [OR] = 2.77, 95% CI = 1.04-7.37) and the belief that ablation was used by colleagues (OR = 13.27, 95% CI = 4.44-39.64) or decreases medical costs (OR = 5.07, 95% CI = 1.00-25.74). CONCLUSIONS: Although few gastroenterologists agreed that ablation is effective, a significant proportion had adopted its use. There was a significant increase in ablation use during our study period, and the characteristic that was most strongly associated with ablation use was the belief that colleagues used it.
AB - OBJECTIVES: Although ablation therapy may be useful in the treatment of Barrett's esophagus, evidence of effectiveness is scarce, and little is known about current utilization of ablation. We aimed to determine whether the use of ablation was increasing in a cohort of gastroenterologists, and to identify physician beliefs and characteristics associated with ablation use. METHODS: We surveyed a national sample of gastroenterologists about ablation use, with an 18-month follow-up. The self-administered instrument included questions about demographic characteristics, attitudes about ablation therapy, and prior experience with ablation. Case scenarios were also included. We used logistic regression to identify factors associated with the use of ablation in patients with Barrett's esophagus. RESULTS: Two hundred seventy-nine (50.3% of those eligible) responded to the baseline survey. Few agreed that ablation lowers the risk of adenocarcinoma (15%) or is supported by the medical literature (19%). However, 25% of respondents reportedly had used ablation at baseline, and this increased to 36% in the follow-up survey (p = 0.0003). The use of ablation was significantly associated with physician age greater than 54 yr (odds ratio [OR] = 2.77, 95% CI = 1.04-7.37) and the belief that ablation was used by colleagues (OR = 13.27, 95% CI = 4.44-39.64) or decreases medical costs (OR = 5.07, 95% CI = 1.00-25.74). CONCLUSIONS: Although few gastroenterologists agreed that ablation is effective, a significant proportion had adopted its use. There was a significant increase in ablation use during our study period, and the characteristic that was most strongly associated with ablation use was the belief that colleagues used it.
UR - http://www.scopus.com/inward/record.url?scp=0036180922&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0036180922&partnerID=8YFLogxK
U2 - 10.1016/S0002-9270(01)04017-5
DO - 10.1016/S0002-9270(01)04017-5
M3 - Article
C2 - 11866262
AN - SCOPUS:0036180922
SN - 0002-9270
VL - 97
SP - 279
EP - 286
JO - American Journal of Gastroenterology
JF - American Journal of Gastroenterology
IS - 2
ER -