Date of Award

2017

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Department Chair

John Cavenagh, MBA, PhD, PA-C

Abstract

Objective: The objective of the selective EBM review is to determine whether or not “Is radiofrequency ablation effective in treating Barrett’s esophagus patients with high-grade dysplasia?”

Study Design: Review of two randomized controlled trials and one cohort study. All three studies were published in English in peer-reviewed journals after 2000.

Data Sources: Two randomized controlled trials and one cohort study found via PubMed.

Outcome(s) Measured: All three studies measured eradication of dysplasia via biopsy evaluation. Other outcomes measured included progression to high-grade dysplasia or adenocarcinoma based on histology findings, overall cancer risk based on observations of patients in the registry, and rate of serious adverse events determined by any event that led to death or required hospitalization.

Results: Phoa et. al and Haidry et. al found that RFA treatment was successful in treating dysplastic Barrett’s esophagus. Though Shaheen et. al found that RFA treatment was successful in eradication of dysplasia, given the poor study design and lack of control group, it cannot be concluded whether or not RFA treatment was successful for patients with high-grade dysplasia.

Conclusions: Based on the results of the Haidry and Phoa studies, RFA was shown to be an successful and cost-effective treatment method for the eradication of dysplastic Barrett’s esophagus. The Shaheen study found that RFA was effective, however it is difficult to assess validity of the data due to lack of a control group throughout the entirety of the study.

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