Research protocols investigating the value and cost of endoscopy in patients with GERD being screened for Barrett's esophagus should be a priority given the clinical and economic importance of this issue. Similarly, the cost-effectiveness of surveillance of this lesion is also important. The optimal PPI test strategy should be determined, as well as the appropriate therapeutic strategy that follows. This will need to be determined in each of the clinical presentations of GERD, both typical and atypical. Finally, we have almost no information regarding appropriate diagnostic and therapeutic strategies of supraesophageal manifestations of GERD. Given the enormous health care burden of asthma alone in this country, this is obviously an area requiring a high priority for research efforts.
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