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Gastroesophageal Reflux DFP

DFP Profile

DFP NAME:

Multidisciplinary Approach for Gastroesophageal Reflux (GERD) DFP

 

MISSION:

In current medical practice, endoscopy has become the primary diagnostic test for evaluating patients with gastroesophageal reflux disease (GERD), while fluoroscopy has been underutilized in the diagnostic work-up of these individuals. The decreasing role of fluoroscopy is related to a variety of factors, including: 1) the wide variability in fluoroscopic training across academic institutions and, as a result, a dwindling pool of radiologists who have the skill or experience needed to perform and interpret high-quality fluoroscopic examinations; 2) an “endoscopy first” mentality by many gastroenterologists that undervalues barium esophagography; and 3) lack of investment in research and development of fluoroscopic contrast agents by academic radiology and industry as well as recurring problems related to shortages or even discontinuation of essential barium products. Despite these issues, barium esophagography remains a relatively inexpensive and noninvasive global examination that provides valuable information about swallowing function, esophageal motility, morphologic abnormalities in the pharynx and esophagus, and GER, potentially obviating the need for fiberoptic examination of swallowing (FEES), manometry, ear-nose-throat (ENT) examination, endoscopy, and 24-hour pH monitoring.

The mission of the panel is to establish the importance of a multidisciplinary approach for GERD that recognizes the important role of barium esophagography in conjunction with endoscopy and other diagnostic tests. This panel will emphasize the value-added service of fluoroscopic examinations in evaluating patients with GERD by providing guidelines for radiologists based on available scientific literature, by addressing educational gaps in fluoroscopic training for performing and interpreting barium esophagograms, by partnering with industry to foster research and development in barium esophagography and develop strategies for increasing awareness of the value of fluoroscopy, and by working in conjunction with gastroenterology to develop a broad consensus about an optimal multidisciplinary approach for evaluating patients with GERD.

 

DFP GOALS:

  1. Partner with gastroenterology, specifically American Gastroenterological Association (AGA) and possibly American Society for Gastrointestinal Endoscopy (ASGE), but that will need more discussion and exploration. Other potential collaborating societies include the Dysphagia Research Society, to develop a consensus statement about an optimal interdisciplinary approach for evaluating patients with GERD that could be published in Abdominal Imaging, the official journal of SAR, and on the SAR website.
  2. Develop a variety of educational tools for performing and interpreting barium esophagograms, including A) swallowing examination protocols for GERD that could be made available on the SAR website; B) plenary sessions/workshops at the annual SAR meeting and other radiology conferences; C) review articles and tutorials that could be published in Abdominal Imaging or other journals and made available on the SAR website; D) site visits to academic radiology centers for direct observation of the procedures; and E) a series of short, directed video tutorials on how to perform and interpret barium esophagograms in the setting of GERD that could be made available on the SAR website, You-Tube, and other locations 
  3. Partner with industry to develop strategies for increasing awareness of the value of barium esophagography as part of a multidisciplinary approach for GERD.
  4. Partner with speech pathology to develop guidelines for detecting pharyngeal complications of GERD by careful evaluation of the pharynx or “modified barium swallows” in the appropriate clinical setting.
  5. Partner with gastroenterology to increase awareness among clinicians about the value of an interdisciplinary approach for GERD by participating in hospital Grand Rounds and annual GI meetings and also contributing review articles to gastroenterology and other clinical journals.


 

SAR GERD DFP Members:

Cheri L. Canon, M.D., F.A.C.R. (Co-Chair)
Professor and Chair of Radiology, Witten-Stanley Endowed Chair of Radiology
University of Alabama at Birmingham School of Medicine
ccanon@uabmc.edu

Marc S. Levine, M.D. (Co-Chair)
Advisory Dean
Professor and Chief of Gastrointestinal Radiology
Perelman School of Medicine at the University of Pennsylvania

Laura R. Carucci, M.D.
Professor of Radiology, Director of MRI and Computed Tomography
Virginia Commonwealth University Medical Center/ Medical College of Virginia

David J. DiSantis, M.D.
Arthur Lieber, M.D. Endowed Professor of Diagnostic Radiology
University of Kentucky College of Medicine

Desiree E. Morgan, M.D.
Professor of Radiology and Vice Chair of Education
University of Alabama at Birmingham School of Medicine

Stephen E. Rubesin, MD
Professor of Radiology
Perelman School of Medicine at the University of Pennsylvania

Mary Ann Turner, M.D., F.A.C.R.
Professor and Vice Chair of Radiology
Virginia Commonwealth University Medical Center/ Medical College of Virginia

Frank J. Scholz, M.D.
Clinical Professor of Radiology, Tufts University School of Medicine
Lahey Hospital & Medical Center

Ellen L. Wolf, M.D.

Professor and Vice Chair of Radiology, Chief, GI Radiology
Montefiore Medical Center


 

Consultants:

David A. Katzka, M.D.
Professor of Medicine, Department of Gastroenterology and Hepatology
Mayo Clinic, Rochester, MN

Mary T. Hawn, M.D., M.P.H.
Professor and Chair of Surgery
Stanford School of Medicine

Bonnie Martin-Harris, Ph.D., CCC-SLP, BCS-S
Professor of Otolaryngology Head & Neck Surgery,
Director of the MUSC Evelyn Trammell Institute for Voice and Swallowing.
Medical University of South Carolina

Julie Peterson, M.S./CCC-SLP
Clinical Sales Specialist for Bracco Diagnostics, Inc

Archie Williams

CEO of Sunapsis, Inc. and Bracco Diagnostics, Inc. Consultant


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