The Use of the Prague Classification System in the Reporting of Barrett’s Surveillance Endoscopies

Abstract

Aims: The Prague classification for the reporting of Barrett’s oesophagus has been validated in previous studies and is recommended by the British Society of Gastroenterologists (BSG) in their latest guidelines. In this short study we aim to audit the adherence to the use of this system in endoscopy reports produced in a busy teaching hospital in the UK.  Methods: We retrospectively audited all the reports for endoscopies performed as surveillance for patients with known Barrett’s oesophagus within a six month period. These reports were examined as to whether or not the Prague classification system was employed. Results: Sixty-seven reports were inspected and six were excluded as Barrett’s was not seen. Twenty-six of the 61 reports studied (43%) used the Prague classification system.  The remainder used descriptions and length measurements felt appropriate by the endoscopist.  Conclusions: The BSG guidelines emphasise the importance of measuring Barrett’s using a standard methodology. The rationale for this include aiding communication, increasing the level of diagnostic confidence and providing an estimate of the risk of adenocarcinoma development based on segment length. The use of the Prague classification is validated, explicit and consensus driven. However our study demonstrates that only 43% of endoscopy reports use the Prague system. The reason for this lack of adherence is unclear and may benefit from further study.