Validation of a risk prediction model for Barrett's esophagus in an Australian population

Ireland, Colin J., Gordon, Andrea L., Thompson, Sarah K., Watson, David I., Whiteman, David C., Reed, Richard L., and Esterman, Adrian (2018) Validation of a risk prediction model for Barrett's esophagus in an Australian population. Clinical and Experimental Gastroenterology, 11. pp. 135-142.

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Background: Esophageal adenocarcinoma is a disease that has a high mortality rate, the only known precursor being Barrett's esophagus (BE). While screening for BE is not cost-effective at the population level, targeted screening might be beneficial. We have developed a risk prediction model to identify people with BE, and here we present the external validation of this model.

Materials and methods: A cohort study was undertaken to validate a risk prediction model for BE. Individuals with endoscopy and histopathology proven BE completed a questionnaire containing variables previously identified as risk factors for this condition. Their responses were combined with data from a population sample for analysis. Risk scores were derived for each participant. Overall performance of the risk prediction model in terms of calibration and discrimination was assessed.

Results: Scores from 95 individuals with BE and 636 individuals from the general population were analyzed. The Brier score was 0.118, suggesting reasonable overall performance. The area under the receiver operating characteristic was 0.83 (95% CI 0.78-0.87). The Hosmer-Lemeshow statistic was p=0.14. Minimizing false positives and false negatives, the model achieved a sensitivity of 74% and a specificity of 73%.

Conclusion: This study has validated a risk prediction model for BE that has a higher sensitivity than previous models.

Item ID: 53569
Item Type: Article (Research - C1)
ISSN: 1178-7023
Keywords: Barrett's esophagus, risk prediction model, screening, validation
Copyright Information: This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.
Funders: National Cancer Institute (NCI)
Projects and Grants: NCI RO1 CA 001833
Date Deposited: 09 May 2018 08:19
FoR Codes: 42 HEALTH SCIENCES > 4202 Epidemiology > 420205 Epidemiological modelling @ 50%
32 BIOMEDICAL AND CLINICAL SCIENCES > 3211 Oncology and carcinogenesis > 321102 Cancer diagnosis @ 50%
SEO Codes: 92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920412 Preventive Medicine @ 50%
92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920102 Cancer and Related Disorders @ 50%
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