Clinical–alimentary tractThe Development and Validation of an Endoscopic Grading System for Barrett’s Esophagus: The Prague C & M Criteria
Section snippets
Working Group Structure and Meetings
A subgroup of the International Working Group for the Classification of Oesophagitis (IWGCO), the authors of this report, was assembled to develop criteria for endoscopic detection and grading of BE that would be useful in both clinical practice and research trials. All the members of the subgroup have a research and clinical interest in BE, and one is a statistician. The first meeting was convened in September 2002, and, here, strategies for development of criteria for grading of BE were
Endoscopic Landmarks and Development of a Classification System
A series of statements about the recognition of key landmarks pertinent to the endoscopic recognition and classification of BE were developed and rated by the group (Table 1). This process highlighted the pivotal importance of accurate localization of the GEJ for the diagnosis of BE and also for the measurement of its extent. Review of the literature relevant to the endoscopic location of the GEJ showed a lack of validation of any of the criteria proposed. None of these criteria were originally
Discussion
At present, standardized, validated criteria for the endoscopic description of BE are not routinely used. Endoscopists currently adopt a loose classification system, defining endoscopic segments of BE as “long,” “short,” or “ultra-short,” without there being an established cutoff or clinical significance for any of these categories.7 Moreover, considerable variation in the ability to detect, classify, and measure the endoscopic extent of BE has been reported.8, 9
To deal with these issues, we
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