Structured Abstract

Contents

• Preface
• Acknowledgements
• Technical Expert Panel
• EPC Program Director
• Executive Summary
• Introduction
• Methods
  • Analytic Framework and Key Questions
  • Search Strategy
  • Study Selection
  • Data Extraction
  • Quality Assessment
  • Critical Appraisal of Systematic Reviews
  • Data Synthesis
  • Peer Review
• Results
  • Key Question 1 What is the evidence of the comparative effectiveness of medical, surgical, and other newer forms of treatments for improving objective and subjective outcomes in patients with chronic gastroesophageal reflux disease (GERD)? Is there evidence that effectiveness varies by specific techniques/procedures or medications? Objective outcomes include esophagitis healing, ambulatory pH, other indicators of reflux, need for medication, health care utilization, and incidence of esophageal stricture, Barrett's esophagus, or esophageal adenocarcinoma. Subjective outcomes include symptom frequency and severity, sleep/productivity, and overall quality of life
  • Key Question 2 Is there evidence that effectiveness of medical, surgical, and newer forms of treatment varies for specific patient subgroups? What are the characteristics of patients who have undergone these therapies, including the nature of previous medical therapy, severity of symptoms, age, sex, weight, and other demographic and medical factors? What are the provider characteristics for procedures, including provider volume and setting (e.g., academic vs. community)?
  • Key Question 3 What are the short-term and long-term adverse events associated with specific medical, surgical, and newer forms of therapies for GERD? Does the incidence of adverse events vary with duration of followup, specific surgical intervention, or patient characteristics?
• Discussion
• Remaining Issues and Future Research Needs
• References
• Abbreviations
• Appendixes
  • Appendix A Search Strategy
  • Appendix B Excluded Studies
  • Appendix C GERD Data Extraction Form

Update of Comparative Effectiveness Review No. 1. Comparative Effectiveness of Management Strategies for Gastroesophageal Reflux Disease

Prepared for: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services¹, Contract No. HHSA 290-2007-10055-I. Prepared by: Tufts Medical Center Evidence-based Practice Center, Boston, Massachusetts

Suggested citation:

Ip S, Chung M, Moorthy D, Yu WW, Lee J, Chan JA, Bonis PA, Lau J. Comparative Effectiveness of Management Strategies for Gastroesophageal Reflux Disease: Update. Comparative Effectiveness Review No. 29. (Prepared by Tufts Medical Center Evidence-based Practice Center under Contract No. HHSA 290-2007-10055-I.) AHRQ Publication No. 11-EHC049-EF. Rockville, MD: Agency for Healthcare Research and Quality. September 2011. Available at: www.effectivehealthcare.ahrq.gov/reports/final.cfm.

This report is based on research conducted by the Tufts Medical Center Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. HHSA 290-2007-10055-I). The findings and conclusions in this document are those of the author(s), who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. No statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.

The information in this report is intended to help health care decisionmakers—patients and clinicians, health system leaders, and policymakers, among others—make well-informed decisions and thereby improve the quality of health care services. This report is not intended to be a substitute for clinical judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical reference and in conjunction with all other pertinent information, i.e., in the context of available resources and circumstances presented by individual patients.

This report may be used, in whole or in part, as the basis for development of clinical practice guidelines and other quality enhancement tools, or as a basis for reimbursement and coverage policies. AHRQ or U.S. Department of Health and Human Services endorsement of such derivative products may not be stated or implied.

None of the investigators have any affiliations or financial involvement that conflicts with the material presented in this report.

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