This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Related letter  • Related article  • Similar articles in JAMA  Topic Collections  • Evidence-Based Medicine  • Gastrointestinal Diseases  • Surgical Interventions  • Endoscopy/ Minimally Invasive Surgery  • Otolaryngology/ Head & Neck Surgery  • Endoscopy of Upper Aerodigestive Tract  • Alert me on articles by topic

	Since this article does not have an abstract, we have provided the first 119 words of the full text and any section headings.

To the Editor: I am surprised that the Clinical Crossroads Update by Dr Burns¹ did not comment on the statement that surveillance upper endoscopy for Barrett esophagus has been performed "every year as that is the patient's preference."¹ Mrs W had undergone 4 annual endoscopic examinations for Barrett esophagus without detecting dysplasia. Such a practice is inconsistent with current specialty society guidelines.^2-3 Endoscopy performed every 3 years would have been appropriate.

Physicians may order tests or prescribe medications that patients request but that are not appropriate. However, a physician's responsibility is to advise the patient about what constitutes sound contemporary evidence-based principles. Medical professionalism should direct clinicians not to perform procedures that are not indicated.

Financial Disclosures: None reported.

Todd LarRieu Sack, MD
tsack@bgclinic.com
Borland-Groover Clinic
Jacksonville, Fla

1. Burns RB. A 59-year-old woman with gastroesophageal reflux disease and Barrett esophagus, 4 years later. JAMA. 2006;296:2140. FREE FULL TEXT 2. Hirota WK, Zuckerman MJ, Adler DG, et al, Standards of Practice Committee, American Society for Gastrointestinal Endoscopy. ASGE guideline: the role of endoscopy in the surveillance of premalignant conditions of the upper GI tract. Gastrointest Endosc. 2006;63:570-580. FULL TEXT | ISI | PUBMED 3. The Society for Surgery of the Alimentary Tract Patient Care Committee. Practice guidelines for patients with gastrointestinal surgical diseases. J Gastrointest Surg. 1998;2:483-484. FULL TEXT | PUBMED

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2007;297:699.

RELATED LETTER

Frequency of Surveillance for Barrett Esophagus—Reply
Risa B. Burns and Tom Delbanco
JAMA. 2007;297(7):699-700.
EXTRACT | FULL TEXT  

RELATED ARTICLE

A 59-Year-Old Woman With Gastroesophageal Reflux Disease and Barrett Esophagus, 4 Years Later
Risa B. Burns
JAMA. 2006;296(17):2140.
EXTRACT | FULL TEXT