Calc Function

  • Diagnosis
  • Rule Out
  • Prognosis
  • Formula
  • Treatment
  • Algorithm
  • Disease
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    Diagnosis and Management of Gastroesophageal Reflux Disease

    Official guideline from the American College of Gastroenterology.

    summary by Rachel Niec, MD Rachel Engelberg, MD

    Diagnosis

    Establishing diagnosis

    Strong recommendation
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    Moderate quality evidence

    Strong recommendation
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    Low quality evidence

    Strong recommendation
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    Moderate quality evidence

    Strong recommendation
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    Low quality evidence

    Strong recommendation
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    Low quality evidence

    Extraesophageal presentation

    Strong recommendation
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    Moderate quality evidence

    Strong recommendation
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    Low quality evidence

    Conditional recommendation
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    Low quality evidence

    Management

    Medical

    Conditional recommendation
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    Moderate quality evidence

    Conditional recommendation
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    Low quality evidence

    Strong recommendation
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    High quality evidence

    Strong recommendation
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    Low quality evidence

    Conditional recommendation
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    Low quality evidence

    Strong recommendation
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    Moderate quality evidence

    Conditional recommendation
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    Moderate quality evidence

    Conditional recommendation
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    Moderate quality evidence

    GERD Refractory to PPIs

    Strong recommendation
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    Low quality evidence

    Conditional recommendation
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    Low quality evidence

    Strong recommendation
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    Low quality evidence

    Strong recommendation
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    Low quality evidence

    Strong recommendation
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    Low quality evidence

    Conditional recommendation
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    Low quality evidence

    Surgical

    Strong recommendation
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    High quality evidence

    Conditional recommendation
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    Moderate quality evidence

    Strong recommendation
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    High quality evidence

    Conditional recommendation
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    Moderate quality evidence

    Risks and Complications

    PPI risks

    Conditional recommendation
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    Moderate quality evidence

    Conditional recommendation
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    Moderate quality evidence

    Conditional recommendation
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    Moderate quality evidence

    Strong recommendation
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    High quality evidence

    Complications

    Strong recommendation
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    Moderate quality evidence

    Conditional recommendation
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    Low quality evidence

    Conditional recommendation
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    Low quality evidence

    Strong recommendation
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    Moderate quality evidence

    Conditional recommendation
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    Low quality evidence

    Conditional recommendation
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    Moderate quality evidence

    Strong recommendation
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    Moderate quality evidence

    How strong is the ACG's recommendation?

    Strong recommendation
    Intervention's desirable effects clearly outweigh undesirable effects.
    Moderate recommendation
    Further research likely to impact confidence in estimate of effect.
    Conditional recommendation
    Uncertainty in tradeoffs between desirable & undesirable effects of intervention.
    Uncertainty in tradeoffs between desirable & undesirable effects of intervention.
    High quality evidence
    Further research unlikely to change guideline authors' confidence in estimate of effect.
    Between high and moderate levels of evidence.
    Moderate quality evidence
    Further research likely to impact confidence in estimate of effect.
    Low quality evidence
    Further research expected to have important impact in confidence in estimate of effect.
    Very low quality evidence
    Effect is very uncertain.