The Michigan Barret's Esophagus pREdiction Tool (M-BERET)
The M-BERET estimates the probability that a man aged 50-79 years old has Barrett’s esophagus. Barrett’s esophagus is a change in the lining of the esophagus (swallowing tube) that is associated with an increased risk of developing cancer of the esophagus (esophageal adenocarcinoma). However, the vast majority of people with Barrett’s esophagus never develop cancer of the esophagus.
The M-BERET was developed from the Newly Diagnosed Barrett’s Esophagus Study conducted at the University of Michigan and the Ann Arbor Veterans Affairs Medical Center1 but has not been validated in other groups of patients. This tool is intended to be used by health professionals. If you are not a health professional, please discuss your risk with your doctor.
The M-BERET is not intended for use in individuals who have previously undergone upper endoscopy. It is also not intended for use in individuals with difficulty swallowing (food getting stuck), unintentional weight loss, or bleeding. Such symptoms may warrant endoscopy regardless of the predicted probability of Barrett’s esophagus.
What is the patient’s sex?
What is the patient’s age?
Heartburn is “a burning sensation in the chest, behind the breastbone, that rises up toward the neck or mouth.
Regurgitation is “the effortless movement of stomach contents up into the chest, throat, or mouth.
Have you smoked at least 100 cigarettes in your life?
What was the most you have smoked per day?
While wearing only underwear or a hospital gown, and standing erect, palpate the hip area to locate the bony right ilium (Figure). Repeat on the left side. Place a soft measuring tape around the trunk in a horizontal plane at the levels of the iliums on both sides of the trunk. This is typically near the level of the umbilicus. Hold the zero-end below the measurement value. Check for horizontal alignment of the measuring tape in front and back. Make sure that the tape is snug, but does not compress the skin. Measure to the nearest 0.1 cm. Repeat the measurement to make sure it is correct.
Measure while standing erect, with feet together, and weight evenly distributed on each foot.
Feel the greater trochanters of the hips (Figure). While making sure the tape remains horizontal, find the maximum circumference, including the buttocks and greater trochanters. Keep the tape snug, without compressing the skin. Make the measurement to the nearest 0.1 cm. Repeat the measurement to make sure it is correct.
1. Rubenstein JH, Morgenstern H, Appelman H, Scheiman J, Schoenfeld P, McMahon L, Metko V, Near E, Kellenberg J, Kalish T, Inadomi JM. Prediction of Barrett’s Esophagus among Men with and without GERD Symptoms. In Submission 2012.
2. Rubenstein JH, Mattek N, Eisen G, Rubenstein JH, Mattek N, Eisen G. Age- and sex-specific yield of Barrett's esophagus by endoscopy indication. Gastrointestinal Endoscopy 2010;71:21-7.
3. Cook MB, Wild CP, Forman D. A systematic review and meta-analysis of the sex ratio for Barrett's esophagus, erosive reflux disease, and nonerosive reflux disease. American Journal of Epidemiology 2005;162:1050-61.
4. Desai TK, Krishnan K, Samala N, Singh J, Cluley J, Perla S, Howden CW. The incidence of oesophageal adenocarcinoma in non-dysplastic Barrett’s oesophagus: a meta-analysis. Gut 2011:published on October 13, 2011 as 10.1136/gutjnl-2011-300730.
5. Spechler SJ, Sharma P, Souza RF, Inadomi JM, Shaheen NJ. American Gastroenterological Association medical position statement on the management of Barrett's esophagus. Gastroenterology 2011;140:1084-91.