John T. Bassett

Walter Reed National Military Medical Center, Washington, Washington, D.C., United States

Are you John T. Bassett?

Claim your profile

Publications (7)32.19 Total impact

  • The American journal of medicine 01/2014; · 5.30 Impact Factor
  • Source
    John T Bassett, Michael L Volk
    [Show abstract] [Hide abstract]
    ABSTRACT: The ultimate purpose of measuring quality of care is to discriminate between healthcare providers in order to motivate improvement. Recently, a set of evidence-based indicators has been proposed for measurement of processes of care for patients with cirrhosis, for example early endoscopy for variceal bleeding. The objective of this study was to determine whether these indicators can be measured in a reliable and automated fashion in routine practice. We applied the top five indicators, based on agreement of a panel of experts, to hospitalized adults at our institution over a 3-year period. Only two of the indicators could be reliably measured on the basis of the published wording, and these two still required physician chart review. After applying some assumptions, the indicators were met in 46-100% of cases. None of the indicators was linked to a single physician or institution in all cases, and none occurred with sufficient frequency to discriminate quality between providers. Measuring quality of care in cirrhosis is a laudable objective, but current indicators are not yet ready for administrative use.
    Digestive Diseases and Sciences 06/2011; 56(12):3488-91. · 2.26 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: An association between eosinophilic esophagitis (EoE) and esophageal motility disorders has been described in small studies. The aim of this study was to describe the prevalence of esophageal motor disorders in a large cohort of adults with EoE and examine whether an association exists between esophageal dysmotility and dysphagia. A retrospective review of esophageal manometry studies in adult EoE patients was performed. Tracings were reviewed for abnormalities including nutcracker esophagus and ineffective swallows, defined as low amplitude peristalsis (<30 mmHg) or non-propagating contractions. Ineffective esophageal motility (IEM) was categorized as mild (30-40% ineffective swallows), moderate (50-60% ineffective swallows), and severe (≥70% ineffective swallows). Dysphagia was graded on a 0-3 scale for frequency and severity. Seventy-five tracings from EoE patients were reviewed (85% male, mean age 41 ± 12 years). IEM was identified in 25 patients and categorized as mild (n = 13), moderate (n = 6), and severe (n = 6). Nutcracker esophagus was found in three patients. There was no significant difference in eosinophil count among the motility groups: normal 46.5 ± 3.1, mild IEM 56.9 ± 36.9, moderate IEM 45.5 ± 23.7, severe IEM 34.3 ± 12.6 (P = 0.157). In this cohort of EoE patients, the majority had normal esophageal motility studies, although a subset of these patients had some esophageal dysmotility. It is unlikely that esophageal dysmotility is a major contributing factor to dysphagia, although it is reasonable to consider esophageal manometry testing in EoE patients to identify potential abnormalities of the smooth muscle esophagus.
    Digestive Diseases and Sciences 03/2011; 56(5):1427-31. · 2.26 Impact Factor
  • Gastroenterology 01/2010; 138(5). · 12.82 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Eosinophilic esophagitis (EoE) is increasingly being diagnosed in adults presenting with dysphagia, food impactions, and chest pain. Studies to date provide conflicting data on the association of EoE and esophageal dysmotility. The objective of this study was to evaluate the prevalence of esophageal dysmotility in a cohort of patients with biopsies consistent with EoE at a military treatment facility. This is a prospective evaluation of consecutively identified patients at our institution diagnosed with EoE from March 1, 2005 to June 1, 2007. Thirty-two patients with biopsies consistent with EoE completed a symptom survey and 30 underwent esophageal manometry. The majority of EoE patients (23/30, 77%) had a normal end-expiratory lower esophageal sphincter (LES) pressure (normal range 10-35), whereas six patients had a low-normal LES pressure (6-9 mm Hg) and one patient had a decreased LES pressure (<5 mm Hg). Five patients (15.6%) were diagnosed with a nonspecific esophageal motor disorder (NSEMD). Two patients had high mean esophageal amplitude contractions >180 mm Hg (188 mm Hg, 209 mm Hg). No patient was diagnosed with nutcracker esophagus or diffuse esophageal spasm. Patients with and without NSEMD reported a similar degree of swallowing difficulty, heartburn, belching, chest pain, regurgitation, symptoms at night, and total symptom score. Likewise, eosinophil count on mucosal biopsy was similar between patients with and without a NSEMD. In this cohort, we found the prevalence of an NSEMD to be similar to that of a 10% prevalence found in a gastroesophageal reflux population.
    Diseases of the Esophagus 03/2009; 22(6):543-8. · 1.64 Impact Factor
  • John T Bassett, Ganesh R Veerappan, Dong H Lee
    Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association 09/2008; 6(11):A26. · 5.64 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background The mainstay of medical therapy for Barrett’s esophagus is normalization of esophageal acid exposure with proton pump inhibitors (PPIs). However, the optimal dose and whether once daily or twice daily is required for acid suppression is unknown. Aim The purpose of this study was to assess whether adequate intra-esophageal acid suppression could be achieved with once daily versus twice daily omeprazole in patients with gastroesophageal specialized intestinal metaplasia (GEJSIM), short-segment (SSBE) and long-segment Barrett’s esophagus (LSBE). Methods Patients with GEJSIM and Barrett’s esophagus underwent upper endoscopy with 48-h wireless pH capsule while on once daily 20 mg omeprazole for at least 1 week. If intra-esophageal acid was not adequately controlled, defined as pH value <4 for greater than 4.2 % of the time during the second 24-h period, omeprazole was increased to twice daily for 1 week and upper endoscopy with wireless pH capsule was repeated. Results A total of 36 patients completed the study (10 patients had GEJSIM, 16 patients had SSBE, and 10 patients had LSBE). Normalization of intraesophageal pH was achieved in 28 patients (78 %) with once daily PPI and eight patients required twice daily PPI. There was no significant difference between the three groups in the proportion of patients requiring high dose PPI (GEJSIM 10 %, SSBE 25 %, LSBE 30 %, p = 0.526). Conclusions The majority of patients with Barrett’s esophagus were controlled with once daily low dose PPI and only a minority required twice daily dosing, regardless of the length of Barrett’s mucosa.
    Digestive Diseases and Sciences 58(8). · 2.26 Impact Factor

Publication Stats

25 Citations
32.19 Total Impact Points

Institutions

  • 2014
    • Walter Reed National Military Medical Center
      • Department of Gastroenterology
      Washington, Washington, D.C., United States
  • 2011
    • University of Michigan
      • Division of Gastroenterology
      Ann Arbor, MI, United States
  • 2009–2011
    • Naval Hospital Bremerton
      Bremerton, Washington, United States
    • Naval Hospital Camp Lejeune
      North Carolina, United States