A three-arm randomized controlled trial depicted that the tissue systems pathology-9 (TSP-9) test had the potential to enhance health outcomes by facilitating risk-aligned decision-making for treating Barrett's esophagus. Researchers aimed to assess whether the TSP-9 test had a positive impact on adherence to clinical guidelines for the management of Barrett's esophagus.

This trial was executed utilizing two different approaches. In intervention 1, participants were given TSP-9 results, while in intervention 2, volunteers were given the choice to request TSP-9 results. Data was gathered from 259 practising gastrointestinal surgeons and gastroenterologists who assessed and determined the management for three simulated Barrett's esophagus subject categories: those with non-dysplastic Barrett's esophagus, those with an indefinite dysplasia status, and those with low-grade dysplasia.

Intervention 1 exhibited a notable increase in the accurate assessment of the risk of progression to high-grade dysplasia/esophageal adenocarcinoma and the provision of treatment as per U.S. society guidelines when compared to the control group (+6.9% to +12.3%). No discernable difference was witnessed in the utilization of guideline-recommended endoscopic eradication therapy. However, in cases necessitating annual endoscopic surveillance, a substantial enhancement was observed in adherence within intervention 1, showing a difference-in-difference of +18.5%.

In intervention 2, the TSP-9 test was requested in 21.9% of cases. Those who ordered the test demonstrated performance similar to that of intervention 1, while those who did not were comparable to the control group. The TSP-9 test enhanced compliance with clinical guidelines for monitoring and treating people with Barrett's esophagus, whether they were at high or low risk of disease progression.