Evidence map›Paper›PMID 37436841›Full record

ArticleJournal of clinical gastroenterology

Improving Adherence to Clinical Practice Guidelines for Managing Gastric Intestinal Metaplasia Among Gastroenterologists at a US Academic Institution.

Jake Jacob, Valentine Millien, Scott Berger, Ruben Hernaez, Gyanprakash A Ketwaroo, Avegail G Flores, Jason K Hou, Maria E Jarbrink-Sehgal, Natalia I Khalaf, Daniel G Rosen and 2 more

Open access · greenAbstract read
In one paragraph

Article in Journal of clinical gastroenterology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
2.5field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 8 citations in OpenAlex.

  1. Gastric intestinal metaplasia: Management and surveillance strategies.World journal of gastrointestinal pathophysiology · 2026
    Review
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 6 institutions in 1 country.

Jake JacobSection of Gastroenterology and Hepatology.
Valentine MillienHouston Methodist Gastroenterology Associates.
Scott BergerDepartment of Medicine, Baylor College of Medicine.
Ruben HernaezSection of Gastroenterology and Hepatology.
Gyanprakash A KetwarooSection of Digestive Diseases, Department of Medicine, Yale School of Medicine, New Haven, CT.
Avegail G FloresSection of Gastroenterology and Hepatology.
Jason K HouSection of Gastroenterology and Hepatology.
Maria E Jarbrink-SehgalSection of Gastroenterology and Hepatology.
Natalia I KhalafSection of Gastroenterology and Hepatology.
Daniel G RosenPathology, Michael E. DeBakey VA Medical Center, Houston, TX.
Hashem B El-SeragDepartment of Medicine, Baylor College of Medicine.
Mimi C TanSection of Gastroenterology and Hepatology.
Baylor College of Medicine · USCenter for Innovation · USMichael E. DeBakey VA Medical Center · USUniversity Gastroenterology · USHouston Methodist · USYale University · US

Funding

Development and Validation of an Automated Algorithm for Real-time Detection of Neoplasia in Barrett's Esophagus using a Low-cost, Portable MicroendoscopeK23DK129776 · NIDDK · BAYLOR COLLEGE OF MEDICINE · PI Mimi Chang Tan · 2022 to 2026
$993k
HSRD VA IK2 HX003346NIDDK NIH HHS K23 DK129776
6 · The paper itself

Abstract

backgroundClinical guidelines reserve endoscopic surveillance after a gastric intestinal metaplasia (GIM) diagnosis for high-risk patients. However, it is unclear how closely guidelines are followed in clinical practice. We examined the effectiveness of a standardized protocol for the management of GIM among gastroenterologists at a US hospital.

methodsThis was a preintervention and postintervention study, which included developing a protocol and education of gastroenterologists on GIM management. For the preintervention study, 50 patients with GIM were randomly selected from a histopathology database at the Houston VA Hospital between January 2016 and December 2019. For the postintervention study, we assessed change in GIM management in a cohort of 50 patients with GIM between April 2020 and January 2021 and surveyed 10 gastroenterologists. The durability of the intervention was assessed in a cohort of 50 GIM patients diagnosed between April 2021 and July 2021.

resultsIn the preintervention cohort, GIM location was specified (antrum and corpus separated) in 11 patients (22%), and Helicobacter pylori testing was recommended in 11 of 26 patients (42%) without previous testing. Gastric mapping biopsies were recommended in 14% and surveillance endoscopy in 2%. In the postintervention cohort, gastric biopsy location was specified in 45 patients (90%, P <0.001) and H. pylori testing was recommended in 26 of 27 patients without prior testing (96%, P <0.001). Because gastric biopsy location was known in 90% of patients ( P <0.001), gastric mapping was not necessary, and surveillance endoscopy was recommended in 42% ( P <0.001). One year after the intervention, all metrics remained elevated compared with the preintervention cohort.

conclusionsGIM management guidelines are not consistently followed. A protocol for GIM management and education of gastroenterologists increased adherence to H. pylori testing and GIM surveillance recommendations.

Indexed as

GastroenterologistsHelicobacter InfectionsHelicobacter pyloriPrecancerous ConditionsStomach NeoplasmsGastroscopyHumansMetaplasia

Identifiers

PMID37436841
PMCPMC10787041
OpenAlexW4384028984

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.