{"title":"Health state utility is substantially reduced with an increasing burden of patient-reported symptoms in eosinophilic esophagitis.","authors":"Cary C Cotton,Mousumi Biswas,Evan S Dellon","doi":"10.14309/ajg.0000000000003106","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003106","url":null,"abstract":"BACKGROUNDWe aimed to estimate health state utility in eosinophilic esophagitis (EoE) by histologic activity and assess association with disease parameters.METHODSIn this cross-sectional study, we measured health state utility by time trade-off and assessed symptoms with the EoE Symptom Activity Index (EEsAI).RESULTSIn 51 adults with EoE, mean utility was 0.91 (95% CI 0.86, 0.95). Utility was numerically worse in patients with dilation or a smaller stricture diameter. With each ten-point improvement in EEsAI, utility increased by 0.03 (95% CI 0.01, 0.05).DISCUSSIONEoE is associated with reduced health state utility, with symptoms most strongly predicting valuation.","PeriodicalId":520099,"journal":{"name":"The American Journal of Gastroenterology","volume":"56 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142328828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Addressing Additional Limitations in the Study on Small Intestine Cancer Risk in Patients With Inflammatory Bowel Disease.","authors":"Ching-Pin Lin,Poi Kuo,James Cheng-Chung Wei","doi":"10.14309/ajg.0000000000003053","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003053","url":null,"abstract":"","PeriodicalId":520099,"journal":{"name":"The American Journal of Gastroenterology","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142328829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Small Bowel Microbiome Profiles in Overweight and Obese Humans.","authors":"Liqi Li","doi":"10.14309/ajg.0000000000003071","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003071","url":null,"abstract":"","PeriodicalId":520099,"journal":{"name":"The American Journal of Gastroenterology","volume":"453 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142324920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohammed El-Dallal,Rajan Lamichhane,Ahmed Sherif,Wesam Frandah
{"title":"Request for Clarification on Sample Size Calculation and Statistical Analysis.","authors":"Mohammed El-Dallal,Rajan Lamichhane,Ahmed Sherif,Wesam Frandah","doi":"10.14309/ajg.0000000000003063","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003063","url":null,"abstract":"","PeriodicalId":520099,"journal":{"name":"The American Journal of Gastroenterology","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142324919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Arantzazu Izagirre,Cristina Sarasqueta,Joel Flores-Arriaga,María C Aso,María Pérez,Jan Tack,I-Hsuan Huang,Ami D Sperber,Olafur S Palsson,Shrikant I Bangdiwala,Mauro D'Amato,Ángel Lanas,Beatriz Lobo,Carmen Alonso-Cotoner,Javier Santos,Luis Bujanda
{"title":"Worldwide Prevalence and Description of Cyclic Vomiting Syndrome According to the Results of the Rome Foundation Global Epidemiology Study.","authors":"Arantzazu Izagirre,Cristina Sarasqueta,Joel Flores-Arriaga,María C Aso,María Pérez,Jan Tack,I-Hsuan Huang,Ami D Sperber,Olafur S Palsson,Shrikant I Bangdiwala,Mauro D'Amato,Ángel Lanas,Beatriz Lobo,Carmen Alonso-Cotoner,Javier Santos,Luis Bujanda","doi":"10.14309/ajg.0000000000003105","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003105","url":null,"abstract":"BACKGROUND AIMSCyclic vomiting syndrome (CVS) is a disorder of gut-brain interaction (DGBI) of unknown origin. This study aimed to evaluate the global prevalence of this disorder and its associated factors.METHODSData were collected from nationwide Internet surveys in 26 countries, with subjects evenly distributed by age, sex and country. The survey included the Rome IV questionnaire as well as an extensive supplemental questionnaire to evaluate additional factors.RESULTS54,127 participants completed the questionnaire (51% male, mean age 44.3 years). The pooled prevalence of CVS was 0.3% (95% CI 0.3-0.4%; n=187), highest in Brazil (1%, 95% CI 0.6-1.5), and lowest in Japan and Germany (with no subject who fulfilled the criteria for CVS). The mean age of participants with CVS was 36.7 years (standard deviation 13.5) and it was more common in females (56.7% vs 43.5%). Factors independently associated with this syndrome were female sex (OR 1.52, 95% CI 1.13-2.03), young age (OR 2.57, 95% CI 1.34-4.94, for people between the ages of 18 and 39 years, compared to those older than 65 years), depression (OR 3.14, 95% CI 2.05-4.82, p<0.001) and anxiety (OR 1.79, 95% CI 1.15-2.78, p<0.001). Individuals with CVS had impaired quality of life (QoL) (PROMIS-10 score: physical QoL mean, 12.9 vs 15.5, p<0.001; mental QoL mean 12.3 vs 14.4, p<0.001) compared to others.CONCLUSIONSCVS is a relatively common disorder that has a negative impact on quality of life. It is important to raise awareness on this syndrome to avoid underdiagnosis and improve clinical practice.","PeriodicalId":520099,"journal":{"name":"The American Journal of Gastroenterology","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142320972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kelly Issokson,Dale Young Lee,Andres J Yarur,James D Lewis,David L Suskind
{"title":"The Role of Diet in Inflammatory Bowel Disease Onset, Disease Management, and Surgical Optimization.","authors":"Kelly Issokson,Dale Young Lee,Andres J Yarur,James D Lewis,David L Suskind","doi":"10.14309/ajg.0000000000003085","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003085","url":null,"abstract":"The concept of using diet as therapy in inflammatory bowel disease (IBD) is of interest to clinicians and patients. Once considered to play a minor role, diet is now known to affect not only disease onset but may also serve as a therapeutic tool for inducing and maintaining remission and improving surgical outcomes. Further research is needed to fully elucidate how, when, and in whom diet therapies may be best applied to improve clinical and disease outcomes. The aim of this review is to summarize current research findings and serve as a tool to help facilitate patient-clinician conversations.","PeriodicalId":520099,"journal":{"name":"The American Journal of Gastroenterology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142273466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Theodore Rokkas,Konstantinos Ekmektzoglou,Yaron Niv,David Y Graham
{"title":"Comparative efficacy and safety of Potassium-Competitive Acid Blocker (P-CAB) based dual, triple and quadruple regimens for first line H. pylori infection treatment: A systematic review and network meta-analysis.","authors":"Theodore Rokkas,Konstantinos Ekmektzoglou,Yaron Niv,David Y Graham","doi":"10.14309/ajg.0000000000003084","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003084","url":null,"abstract":"BACKGROUND AIMSIn the last few years numerous new P-CAB based RCTs concerning first-line regimens for H. pylori infection treatment from various countries have been published. However, no NWM exists which examines the comparative efficacy and safety of P-CAB based dual, triple and quadruple treatments and therefore, in this network meta-analysis (NWM) we examined this matter comparing efficacy and safety of these P-CAB based regimens.METHODSDatabases were searched for identification, screening, eligibility and inclusion of relevant randomized controlled trials (RCTs). Extracted data were entered into a Bayesian NWM and the ranking order for each regimen was evaluated by means of surfaces under cumulative ranking area (SUCRA) values.RESULTSTwenty-five eligible RCTs were included with 7,605 patients randomized to 6 first line regimens, i.e. PCAB-DUAL, PCAB-TRIPLE, PCAB-QUADRUPLE, PPI-DUAL, PPI-TRIPLE, and PPI- QUADRUPLE. The SUCRA values (%) for these 6 regimens were 92.7, 62.5, 33.9, 75.1, 19.4 and 16.3 respectively. The comparative effectiveness ranking showed that PCAB-DUAL regimen ranked first for efficacy and last for adverse effects and had the best profile for integrated efficacy-safety.CONCLUSIONSIn this NWM concerning the comparative efficacy and safety of P-CAB based dual, triple and quadruple regimens for first line H. pylori infection treatment, the overall results showed that PCAB based dual treatment ranked first for efficacy with the best-integrated efficacy-safety profile. This is of importance, since the dual regimens overcome the crucial issue of clarithromycin resistance. Consequently, these findings are expected to be useful in helping clinical decision-making and future guidelines.","PeriodicalId":520099,"journal":{"name":"The American Journal of Gastroenterology","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142273467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Guidelines in Practice: Alcohol-Associated Liver Disease.","authors":"Ashwani K Singal,Loretta Jophlin,Vijay H Shah","doi":"10.14309/ajg.0000000000003047","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003047","url":null,"abstract":"","PeriodicalId":520099,"journal":{"name":"The American Journal of Gastroenterology","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142175058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chang Woo Kim,Hyunjin Kim,Hyoung Rae Kim,Daeyeon David Won,Woo Jung Nam,Byung Soh Min,Tae Jeong Oh,Sungwhan An,Suk-Hwan Lee
{"title":"A Stool DNA-Based SDC2 Methylation Test for the Early Detection of Colorectal Cancer in an Asymptomatic, High-Risk Population: A Multicenter Prospective Randomized Trial.","authors":"Chang Woo Kim,Hyunjin Kim,Hyoung Rae Kim,Daeyeon David Won,Woo Jung Nam,Byung Soh Min,Tae Jeong Oh,Sungwhan An,Suk-Hwan Lee","doi":"10.14309/ajg.0000000000003044","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003044","url":null,"abstract":"INTRODUCTIONNoninvasive stool DNA-based methylation testing has emerged as an effective strategy for the early colorectal cancer (CRC) detection. Syndecan-2 (SDC2) methylation frequently occurs in all stages of CRC; therefore, the aim of this study was to evaluate the clinical performance of a stool DNA-based SDC2 methylation test for detecting CRC in asymptomatic or high-risk CRC populations.METHODSThis multicenter prospective study was conducted to determine the clinical performance of the SDC2 methylation test on stool DNA using real-time polymerase chain reaction. Stool samples were collected from asymptomatic individuals before colonoscopy, and the test results were independently analyzed through comparison with colonoscopic findings and pathological outcomes as reference standards.RESULTSOf the 1,124 evaluable participants, 20 had CRC, 73 had advanced adenomatous polyps (≥1.0 cm), 469 had nonadvanced adenomatous polyps (<1.0 cm), 178 had non-neoplastic polyps, and 384 had negative colonoscopy results. The stool SDC2 methylation test had a sensitivity and specificity of 95.0% and 81.5%, respectively, for detecting CRC, while the sensitivity for detecting advanced adenomatous polyps and CRC was 58.1%. The rate of adenoma detection increased with polyp size (P < 0.01), and sensitivity was not associated with CRC stage (P = 0.864).DISCUSSIONThe stool DNA-based SDC2 methylation test attained a high sensitivity for CRC detection in an asymptomatic high-risk population. Further large-scale clinical studies are required to validate the clinical utility of this test as a population-based CRC screening tool.","PeriodicalId":520099,"journal":{"name":"The American Journal of Gastroenterology","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142261423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Development and Validation of a Clinical Nomogram for Predicting Complications From Pediatric Multiple Magnet Ingestion: A Large Retrospective Study.","authors":"Yizhen Luo,Xiongjian Cui,Jianli Zhou,Yijiang Zhuang,Chenrui Zheng,Qiru Su,Yungen Gan,Zhiyong Li,Hongwu Zeng","doi":"10.14309/ajg.0000000000002983","DOIUrl":"https://doi.org/10.14309/ajg.0000000000002983","url":null,"abstract":"INTRODUCTIONThis study aimed to develop and validate a reliable nomogram based on clinical factors to predict complications associated with pediatric multiple magnet ingestion, addressing the urgency and controversy surrounding its management.METHODSPatients aged 0-18 years with multiple magnet ingestion diagnosed at the Shenzhen Children's Hospital between January 2017 and December 2023 were enrolled. Clinical data were analyzed using least absolute shrinkage and selection operator regression and multifactor logistic regression analyses to screen for risk factors. A model was constructed, and a nomogram was plotted. Model performance was evaluated and internally validated using the area under the curve (AUC), Hosmer-Lemeshow test, calibration curve, decision curve analysis, and 1,000 bootstraps. We calculated the optimal cutoff value, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the prediction model.RESULTSOf the 146 patients, 57 (39.0%) experienced complications. The nomogram included age, multiple ingestions, vomiting, abdominal pain, and abdominal tenderness. The AUC was 0.941, and the internally validated AUC was 0.930. The optimal cutoff value selected as a predictive value was 0.534, with a sensitivity of 82.5%, specificity of 93.3%, positive predictive value of 88.7%, negative predictive value of 89.3%, and accuracy of 89.0%. The Hosmer-Lemeshow test yielded a P value of 0.750. The calibration plot exhibited high consistency in prediction, and decision curve analysis showed excellent net benefits.DISCUSSIONOur nomogram demonstrates excellent discrimination, calibration, and clinical utility and may thus help clinicians accurately assess the risk of complications from pediatric multiple magnet ingestion.","PeriodicalId":520099,"journal":{"name":"The American Journal of Gastroenterology","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142261425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}