Open AccessA predictive Bayesian network that risk stratifies patients undergoing Barrett’s surveillance for personalized risk of developing malignancy
Author(s) -
Alison Bradley,
Sharukh Sami,
N G Hwei,
Anne Macleod,
Manju Nadh Prasanth,
Muneeb Zafar,
Niroshini Hemadasa,
Gregg Neagle,
Isobelle Rosindell,
Jeyakumar Apollos
Publication year - 2020
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0240620
Subject(s) - barrett's esophagus , medicine , aspirin , dysplasia , adenocarcinoma , esophageal adenocarcinoma , malignancy , bayesian network , computer science , cancer , artificial intelligence
Background Barrett’s esophagus is strongly associated with esophageal adenocarcinoma. Considering costs and risks associated with invasive surveillance endoscopies better methods of risk stratification are required to assist decision-making and move toward more personalised tailoring of Barrett’s surveillance. Methods A Bayesian network was created by synthesizing data from published studies analysing risk factors for developing adenocarcinoma in Barrett’s oesophagus through a two-stage weighting process. Results Data was synthesized from 114 studies (n = 394,827) to create the Bayesian network, which was validated against a prospectively maintained institutional database (n = 571). Version 1 contained 10 variables (dysplasia, gender, age, Barrett’s segment length, statin use, proton pump inhibitor use, BMI, smoking, aspirin and NSAID use) and achieved AUC of 0.61. Version 2 contained 4 variables with the strongest evidence of association with the development of adenocarcinoma in Barrett’s (dysplasia, gender, age, Barrett’s segment length) and achieved an AUC 0.90. Conclusion This Bayesian network is unique in the way it utilizes published data to translate the existing empirical evidence surrounding the risk of developing adenocarcinoma in Barrett’s esophagus to make personalized risk predictions. Further work is required but this tool marks a vital step towards delivering a more personalized approach to Barrett’s surveillance.