With publication of a follow-up report on the Department of Veterans
Affairs cooperative trial comparing long-term outcomes of medical and surgical
therapy for gastroesophageal reflux disease (GERD) by Spechler et al in this
issue of THE JOURNAL,1 it is clear that the
decision to pursue antireflux surgery has not gotten any simpler. The status
of the medical and surgical cohorts is reported 10 to 13 years after initial
enrollment in the trial making this report the most complete, longest-term,
and most carefully collected data available. By all standards, these patients
had severe GERD, evident by the high proportion who had esophageal ulcers,
strictures, or Barrett esophagus at baseline. Common wisdom argues that this
is the group most likely to benefit from antireflux surgery: surgical correction
is long-lasting, replaces antisecretory medications, and eliminates the subsequent
cancer risk—or so the argument goes.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 17
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
Figure 22.1-2. Cost-effectiveness Plane and Sensitivity Analysis on Price of H2RAs
Figure 22.1-3. Probabilistic Sensitivity Analysis and Cost-effectiveness Acceptability Curves...
All results at
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.