{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T22:01:52Z","timestamp":1791669712530,"version":"4.3.4"},"reference-count":24,"publisher":"Wiley","issue":"11-12","license":[{"start":{"date-parts":[[2023,10,16]],"date-time":"2023-10-16T00:00:00Z","timestamp":1697414400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Predictive models for eosinophilic oesophagitis (EoE) may not fully rule in the diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To develop a reverse model that predicts against EoE to eliminate the need for oesophageal biopsies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this two\u2010centre study, a predictive model was developed (Mayo Clinic) and validated (University of North Carolina [UNC]). Cross\u2010sectional data from consecutive adult patients without prior EoE who underwent upper enoscopy with oesophageal biopsies were used. EoE cases had \u226515 eosinophils\/high\u2010power field while controls had no eosinophils. Data were collected on patient clinical and endoscopic features. Multiple variable logistic regression was used to identify predictors of non\u2010EoE status while maintaining specificity \u226595%. A secondary model was developed to predict against the need for endoscopy in patients suspected of having EoE without alarm symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The Mayo and UNC cohorts consisted of 345 (EoE\u2009=\u200994, non\u2010EoE\u2009=\u2009251) and 297 patients (EoE\u2009=\u200984, non\u2010EoE\u2009=\u2009213), respectively. A primary model based on clinical and endoscopic features predicted against EoE with c\u2010statistic 0.92 (95% CI: 0.88\u20130.96), specificity 95%, and sensitivity 65%. This model was validated (UNC) with <jats:italic>c<\/jats:italic>\u2010statistic 0.87 (95% CI: 0.82\u20130.92). A simplified scoring system was created and a threshold of \u226512 points excluded EoE with 95% specificity and 50% sensitivity. A secondary model based on clinical characteristics alone predicted against EoE with <jats:italic>c<\/jats:italic>\u2010statistic 0.86 (95% CI: 0.82\u20130.90), specificity 95% and sensitivity 39% and validated (UNC) with c\u2010statistic 0.78 (95% CI: 0.71\u20130.85).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A simplified scoring system accurately identified a group of patients with a low likelihood of EoE where unnecessary oesophageal biopsies can be avoided, potentially resulting in resource and cost savings.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.17772","type":"journal-article","created":{"date-parts":[[2023,10,17]],"date-time":"2023-10-17T04:20:21Z","timestamp":1697516421000},"page":"1143-1150","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Development of a model to identify patients who do not need oesophageal biopsies when eosinophilic oesophagitis is suspected"],"prefix":"10.1111","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8296-1029","authenticated-orcid":false,"given":"Amrit K.","family":"Kamboj","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology Cedars\u2010Sinai Medical Center  Los Angeles California USA"},{"name":"Division of Gastroenterology and Hepatology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cary C.","family":"Cotton","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology University of North Carolina  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang Yen","family":"Liu","sequence":"additional","affiliation":[{"name":"Mayo Clinic School of Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"June","family":"Tome","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana L.","family":"Snyder","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0872-7936","authenticated-orcid":false,"given":"Jeffrey A.","family":"Alexander","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karthik","family":"Ravi","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William S.","family":"Harmsen","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evan S.","family":"Dellon","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology University of North Carolina  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2307-2317","authenticated-orcid":false,"given":"David A.","family":"Katzka","sequence":"additional","affiliation":[{"name":"Department of Digestive and Liver Diseases Columbia University  New York New York 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