A Simple, Interpretable Machine Learning Model Based on Clinical Factors Accurately Predicts Incident Dysplasia or Malignancy in Barrett’s Esophagus

Asge Standards of Practice C. et al. ASGE guideline on screening and surveillance of Barrett’s esophagus. Gastrointest Endosc. 2019;90:335–359 e2.

Killcoyne S, Fitzgerald RC. Evolution and progression of Barrett’s oesophagus to oesophageal cancer. Nat Rev Cancer. 2021;21:731–741.

Article  CAS  PubMed  Google Scholar 

Kerkhof M et al. Grading of dysplasia in Barrett’s oesophagus: substantial interobserver variation between general and gastrointestinal pathologists. Histopathology. 2007;50:920–927.

Article  CAS  PubMed  Google Scholar 

Sangle NA et al. Overdiagnosis of high-grade dysplasia in Barrett’s esophagus: a multicenter, international study. Mod Pathol. 2015;28:758–765.

Article  PubMed  Google Scholar 

Krishnamoorthi R et al. Factors associated with progression of Barrett's esophagus: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2018;16:1046–1055 e8.

Shaheen NJ et al. Diagnosis and management of Barrett’s esophagus: an updated ACG guideline. Am J Gastroenterol. 2022;117:559–587.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Weusten B et al. Diagnosis and management of Barrett esophagus: European society of gastrointestinal endoscopy (ESGE) guideline. Endoscopy. 2023;55:1124–1146.

Article  PubMed  Google Scholar 

Parasa S et al. Development and validation of a model to determine risk of progression of Barrett's esophagus to neoplasia. Gastroenterology. 2018;154: 1282–1289 e2.

Rubenstein JH et al. AGA clinical practice guideline on endoscopic eradication therapy of Barrett’s esophagus and related neoplasia. Gastroenterology. 2024;166:1020–1055.

Article  PubMed  Google Scholar 

Duits LC. et al. Patients with Barrett's esophagus and confirmed persistent low-grade dysplasia are at increased risk for progression to neoplasia. Gastroenterology. 2017;152:993–1001 e1.

Song KY et al. Persistent confirmed low-grade dysplasia in Barrett's esophagus is a risk factor for progression to high-grade dysplasia and adenocarcinoma in a US Veterans cohort. Dis Esophagus. 2020;33.

Deo RC. Machine learning in medicine. Circulation. 2015;132:1920–1930.

Article  PubMed  PubMed Central  Google Scholar 

Taninaga J et al. Prediction of future gastric cancer risk using a machine learning algorithm and comprehensive medical check-up data: a case-control study. Sci Rep. 2019;9:12384.

Article  PubMed  PubMed Central  Google Scholar 

Shaheen NJ et al. Guideline to practice: diagnosis and management of Barrett’s esophagus: an updated ACG guideline. Am J Gastroenterol. 2022;117:1177–1180.

Article  PubMed  PubMed Central  Google Scholar 

Chandrasekar VT et al. Significantly lower annual rates of neoplastic progression in short- compared to long-segment non-dysplastic Barrett’s esophagus: a systematic review and meta-analysis. Endoscopy 2019;51:665–672.

Article  PubMed  Google Scholar 

Glamour BK et al. Age of diagnosis in familial Barrett’s associated neoplasia. Fam Cancer 2022;21:115–120.

Article  CAS  PubMed  Google Scholar 

Krishnamoorthi R et al. Risk of progression in Barrett's esophagus indefinite for dysplasia: a systematic review and meta-analysis. Gastrointest Endosc. 2020;91:3–10 e3.

Kambhampati S et al. Risk factors for progression of Barrett’s esophagus to high grade dysplasia and esophageal adenocarcinoma. Sci Rep. 2020;10:4899.

Article  CAS  Google Scholar 

Sharma P et al. The development and validation of an endoscopic grading system for Barrett’s esophagus: the prague C & M criteria. Gastroenterology. 2006;131:1392–1399.

Article  PubMed  Google Scholar 

Wani S et al. Patients with nondysplastic Barrett's esophagus have low risks for developing dysplasia or esophageal adenocarcinoma. Clin Gastroenterol Hepatol. 2011;9:220–7.

Hampel H, Abraham NS, El-Serag HB. Meta-analysis: obesity and the risk for gastroesophageal reflux disease and its complications. Ann Intern Med 2005;143:199–211.

Article  PubMed  Google Scholar 

Pudjihartono N et al. A review of feature selection methods for machine learning-based disease risk prediction. Front Bioinform. 2022;2:927312.

Article  PubMed  PubMed Central  Google Scholar 

Chawla NV et al. SMOTE: synthetic minority over-sampling technique. J Artif Int Res. 2002;16:321–357.

Google Scholar 

Murdoch WJ et al. Definitions, methods, and applications in interpretable machine learning. Proc Natl Acad Sci USA. 2019;116:22071–22080.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Siddique SM et al. the impact of health care algorithms on racial and ethnic disparities: a systematic review. Ann Intern Med 2024;177:484–496.

Article  PubMed  Google Scholar 

Sun H et al. Machine learning-based prediction models for different clinical risks in different hospitals: evaluation of live performance. J Med Internet Res. 2022;24:e34295.

Article  PubMed  PubMed Central  Google Scholar 

Shung DL et al. Validation of a machine learning model that outperforms clinical risk scoring systems for upper gastrointestinal bleeding. Gastroenterology 2020;158:160–167.

Article  PubMed  Google Scholar 

Iyer PG et al. Development of electronic health record-based machine learning models to predict Barrett’s esophagus and esophageal adenocarcinoma risk. Clin Transl Gastroenterol. 2023;14:e00637.

Article  PubMed  PubMed Central  Google Scholar 

Rubenstein JH et al. Validation and comparison of tools for selecting individuals to screen for Barrett’s esophagus and early neoplasia. Gastroenterology. 2020;158:2082–2092.

Article  PubMed  Google Scholar 

Giddings R et al. Factors influencing clinician and patient interaction with machine learning-based risk prediction models: a systematic review. Lancet Digit Health. 2024;6:e131–e144.

Article  CAS  PubMed  Google Scholar 

Pohl H et al. Length of Barrett’s oesophagus and cancer risk: implications from a large sample of patients with early oesophageal adenocarcinoma. Gut 2016;65:196–201.

Article  PubMed  Google Scholar 

Thota PN et al. Low risk of high-grade dysplasia or esophageal adenocarcinoma among patients with Barrett’s esophagus less than 1 cm (Irregular Z Line) within 5 years of index endoscopy. Gastroenterology. 2017;152:987–992.

Article  PubMed  Google Scholar 

Hamade N et al. Lower annual rate of progression of short-segment vs long-segment Barrett’s esophagus to esophageal adenocarcinoma. Clin Gastroenterol Hepatol. 2019;17:864–868.

Article  PubMed  Google Scholar 

Bergman J et al. An interactive web-based educational tool improves detection and delineation of Barrett's esophagus-related neoplasia. Gastroenterology. 2019;156:1299–1308 e3.

Wani S et al. Endoscopists systematically undersample patients with long-segment Barrett's esophagus: an analysis of biopsy sampling practices from a quality improvement registry. Gastrointest Endosc. 2019;90:732–741 e3.

Zellenrath PA et al. Neoplastic progression risk in females with Barrett's esophagus: a systematic review and meta-analysis of individual patient data. Clin Gastroenterol Hepatol. 2025;23:225–235 e8.

Comments (0)

No login
gif