Comparing Classification Systems for Evaluation of Erosive Esophagitis

Erosive esophagitis is a highly specific indicator of gastroesophageal reflux disease (GERD) after excluding infectious and pill-induced mucosal injury. To ensure accuracy, comparative trials of treatments for esophagitis require a standardized method for classifying endoscopic assessment of esophagitis. However, there are several grading scales for erosive esophagitis. To date, only the Los Angeles (LA) classification system has been validated; this system is based on the extent of visible breaks in the esophageal mucosa. In contrast, the Hetzel-Dent (HD) classification system incorporates evidence of esophageal erythema, friability, and ulceration. To evaluate the intra- and interobserver variation for these 2 grading scales, researchers …