Model predicts EoE even before histology
Click Here to Manage Email Alerts
Using updated diagnostic guidelines, researchers developed a new model identify patients with eosinophilic esophagitis based on clinical features and endoscopic findings, according to study results.
Evan S. Dellon, MD, MPH, of the Center for Esophageal Diseases and Swallowing at the University of North Carolina at Chapel Hill, and colleagues wrote that newer guidelines eliminated the requirement for a proton pump inhibitor trial in patients with potential EoE.
“With the updated A Working Group on Proton-pump Inhibitor Responsive Esophageal Eosinophilia (AGREE) diagnostic guidelines, there are no predictive clinical models and little is known about the diagnostic performance of prior models when an EoE case group includes patients who were previously considered to have PPI-responsive EoE,” they wrote.
Investigators built their predictive models for case-control status, using clinical, endoscopic and histologic features from 206 individuals with EOE and 306 controls. They assessed the model using the area under the receiver-operator characteristic curve (AUC).
Before factoring in endoscopic findings, younger age, male sex, history of atopic condition or food allergy and dysphagia identified patients with EoE with an AUC of 0.83. When researchers included endoscopic findings suggestive of EoE, the AUC increased to 0.92.
The AUC increased even further to 0.99 when investigators included histologic findings.
“Such models can help clinicians make decisions for patients with upper GI symptoms about whether to perform early diagnostic endoscopy or gastroenterology referral for suspicion of EoE,” Dellon and colleagues wrote. “These tools may also help clinicians apply the new AGREE diagnostic criteria to exclude alternative causes of esophageal eosinophilia in cases where biopsy reveal esophageal eosinophilia but EoE diagnosis is uncertain.”
Collapse
Read more about
Click Here to Manage Email Alerts