Clinical Utility of a Non Endoscopic Device EsoCheck and Biomarker EsoGuard as Alternative to Endoscopy for Screening for Barrett's Esophagus in At Risk Population

Study Overview
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Brief Summary
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This will be a prospective randomized, controlled, virtual, patient study to measure the impact of EsoCheck/EsoGuard on health care provider's decision for upper endoscopy referral. The participants will complete two rounds of questions concerning the assessed risk for BE and decision for endoscopy referral of 6 patient cases (clinical vignettes). After the first round has been completed, an EsoCheck/EsoGuard educational information package and the second round of 6 clinical vignettes including EsoGuard results will be sent.

Detailed Description
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This will be a prospective randomized, controlled, virtual, patient study to measure the impact of EsoCheck/EsoGuard on health care provider's decision for upper endoscopy referral. Around 200 US physicians will be asked to participate in this study and at least 100 will be enrolled. Physicians eligible for participation are those whose scope of practice includes preventative care and disease screening - namely screening of BE, such as primary care physicians, family medicine physicians, and general practitioners; physicians whose scope of practice include diagnosis and management of esophageal disease may also participate. The participants will complete two rounds of questions concerning the assessed risk for BE and decision for endoscopy referral of 6 patient cases (clinical vignettes). Per round, there will be 3 different questionnaires consisting of 6 clinical vignettes (A/B/C). Participants will be randomized to questionnaire A, B or C according to the randomization scheme. After the first round has been completed, an EsoCheck/EsoGuard educational information package and the second round of 6 clinical vignettes including EsoGuard results will be sent.

Official Title
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Clinical Utility of a Non Endoscopic Device EsoCheck and Biomarker EsoGuard as Alternative to Endoscopy for Screening for Barrett's Esophagus in At Risk Population (ASBE) A Randomized Controlled, Virtual Patient Trial

Conditions
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Barrett Esophagus

Intervention / Treatment
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* Device: EsoGuard result


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Board-certified physicians whose scope of practice includes preventative care and disease screening, and/or those whose scope of practice include diagnosis and management of esophageal disease (examples include but are not limited to primary care physicians/ general practitioners, family medicine physicians, gastroenterologists, and foregut surgeons); Have between 1 to 40 years of post-residency clinical experience within their field of practice; Have an active panel (whether as part of a group practice, or individually) of over 1000 patients with an adult patient load of more than 50%. Exclusion Criteria: None
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Screening
Allocation: Randomized
Intervention Model: Sequential Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: A1 Control<br>6 Virtual patient cases with GERD and similar BE risk factors as the cases in intervention arm A2 but without an EsoGuard result and in a different order. | |
| Active Comparator: A2 Intervention<br>6 Virtual patient cases with GERD and similar BE risk factors as the cases in the control arm A1 with an EsoGuard result. 5 EsoGuard negative cases (same cases for all intervention questionnaires) and 1 positive EsoGuard case (different for questionnaire A/B/C). | Device: EsoGuard result<br>* Education slide-set EsoGuard and patient cases including EsoGuard result<br>|
| No Intervention: B1 Control<br>6 Virtual patient cases with GERD and similar BE risk factors as the cases in intervention arm B2 but without an EsoGuard result and in a different order. | |
| Active Comparator: B2 Intervention<br>6 Virtual patient cases with GERD and similar BE risk factors as the cases in the control arm B1 with an EsoGuard result. 5 EsoGuard negative cases (same cases for all intervention questionnaires) and 1 positive EsoGuard case (different for questionnaire A/B/C). | Device: EsoGuard result<br>* Education slide-set EsoGuard and patient cases including EsoGuard result<br>|
| No Intervention: C1 Control<br>6 Virtual patient cases with GERD and similar BE risk factors as the cases in intervention arm C2 but without an EsoGuard result and in a different order. | |
| Active Comparator: C2 Intervention<br>6 Virtual patient cases with GERD and similar BE risk factors as the cases in the control arm C1 with an EsoGuard result. 5 EsoGuard negative cases (same cases for all intervention questionnaires) and 1 positive EsoGuard case (different for questionnaire A/B/C). | Device: EsoGuard result<br>* Education slide-set EsoGuard and patient cases including EsoGuard result<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The impact of EsoCheck/EsoGuard on health care provider's decision for upper endoscopy referral | The change in the percentage/rate of virtual patient cases who will be referred for endoscopy in the intervention round compared to the control round. The proportion of patient cases in round 2 for which the provider indicated that the EsoGuard result influenced his/her decision to refer the patient for upper endoscopy divided by all patient cases in round 2. | 1 month | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The impact of EsoCheck/EsoGuard on health care provider's patient risk assessment for BE | The change in the provider's virtual patient risk assessment for BE in the intervention round compared to the control round. | 1 month |