Response to Feuerstein J et al. “Systematic Analysis and Critical Appraisal of the Quality of the Scientific Evidence and Conflicts of Interest in Practice Guidelines (2005–2013) for Barrett’s Esophagus”. doi:10.1007/s10620-016-4222-2

Excerpt

We read with interest the article by Feuerstein et al. “Systematic analysis and critical appraisal quality of the scientific evidence and conflicts of interest in practice guidelines (2005–2013) for Barrett’s esophagus” [8]. We note the omission of our international consensus guidelines on management of Barrett’s esophagus [1, 2] from this appraisal. While our recent guideline on the management of non-dysplastic and low-grade dysplasia in Barrett’s osophagus “BOB CAT” [2] is outside the date limits of their search for evidence, our 2012 guideline “BAD CAT” [1] should have been retrieved. This guideline was funded and endorsed by numerous international societies, and the resulting publication is highly cited and accredited by NICE (UK) [3]. BAD CAT [1] involved an international panel of 92 authors, and 11,000 articles were assessed on the management of Barrett’s dysplasia and early-stage esophageal adenocarcinoma. Since the management of Barrett’s with dysplasia was not explicitly excluded from the review, it appears that there is no rationale for the exclusion of the BAD CAT guideline. Had our guideline been included, the authors would have noted that we addressed many of the problems and shortcomings identified by their review of other guidelines, using the AGREE II instrument. Specifically, we assessed both the quality of the scientific evidence included in the review using GRADE [4] and reported conflict of interest declarations in detail. The guideline production method was inclusive, with input from all areas of clinical specialty and patient groups; there was consideration of adverse events and harms; it was peer-reviewed prior to publication, and we identified areas which were directly applicable to clinical management. As an evidence-based consensus group, we sought to maintain editorial independence and collected information about conflict of interest. Any participants who did not provide a conflict of interest statement were excluded from authorship, to ensure the impartiality of the process. …