EXAMINING THE PREVALENCE, PATIENT PROFILES, AND EXPERIENCES OF MODIFIABLE LIFESTYLE BEHAVIOURS IN INDIVIDUALS WITH BARRETT’S OESOPHAGUS: A SCOPING REVIEW PROTOCOL

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Managing reflux symptoms such as heartburn and regurgitation is important for improving quality of life and reducing the risk of disease progression. Clinical guidelines recommend lifestyle modification alongside surveillance and medication, as factors such as diet, physical activity, smoking, alcohol use, and weight management can influence both symptom control and overall well-being. However, little is known about how people with Barrett’s oesophagus engage with these behaviours, what challenges they face in making changes, or how engagement differs across patient groups. This protocol outlines a scoping review that will map existing evidence on modifiable lifestyle behaviours in people with Barrett’s oesophagus, including their prevalence, lived experience, and variation across subgroups. Methods This scoping review will follow the Joanna Briggs Institute (JBI) methodology. A three-step search strategy will be used to identify both peer-reviewed and grey literature: (1) a limited initial search to refine keywords, (2) a comprehensive search across databases, and (3) backward and forward citation searching. Both qualitative and quantitative studies reporting on the prevalence, variation, or lived experience of lifestyle behaviours in adults with Barrett’s oesophagus will be included. Screening and data charting will be conducted using Covidence. Data will be synthesised narratively and descriptively across three domains: prevalence, variation by patient characteristics, and lived experience and reported in line with the PRISMA-ScR guidelines. Conclusion This scoping review will map the existing evidence on modifiable lifestyle behaviours in individuals with Barrett’s Oesophagus, including how these behaviours are experienced and influenced by patient characteristics. The findings will identify key evidence gaps and provide a foundation to inform future research and the development of tailored interventions to support behaviour change and improve quality of life in this population. " } { "@context": "http://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": "1", "item": { "@id": "https://hrbopenresearch.org/", "name": "Home" } }, { "@type": "ListItem", "position": "2", "item": { "@id": "https://hrbopenresearch.org/browse/articles", "name": "Browse" } }, { "@type": "ListItem", "position": "3", "item": { "@id": "https://hrbopenresearch.org/articles/8-132", "name": "EXAMINING THE PREVALENCE, PATIENT PROFILES, AND EXPERIENCES OF MODIFIABLE..." } } ] } Home Browse EXAMINING THE PREVALENCE, PATIENT PROFILES, AND EXPERIENCES OF MODIFIABLE... ALL Metrics - Views Downloads Get PDF Get XML Cite How to cite this article Cooke D, O'Kane S, Mockler D et al. EXAMINING THE PREVALENCE, PATIENT PROFILES, AND EXPERIENCES OF MODIFIABLE LIFESTYLE BEHAVIOURS IN INDIVIDUALS WITH BARRETT’S OESOPHAGUS: A SCOPING REVIEW PROTOCOL [version 1; peer review: 1 approved] . HRB Open Res 2025, 8 :132 ( https://doi.org/10.12688/hrbopenres.14312.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Study Protocol EXAMINING THE PREVALENCE, PATIENT PROFILES, AND EXPERIENCES OF MODIFIABLE LIFESTYLE BEHAVIOURS IN INDIVIDUALS WITH BARRETT’S OESOPHAGUS: A SCOPING REVIEW PROTOCOL [version 1; peer review: 1 approved] Diana Cooke https://orcid.org/0009-0009-2919-5618 1 , Sedina O'Kane https://orcid.org/0009-0007-9938-8445 2 , David Mockler https://orcid.org/0000-0001-6171-8751 3 , Juliette Hussey 1,4 , Olinda Santin 5 , Emer Guinan 1,4 Diana Cooke https://orcid.org/0009-0009-2919-5618 1 , Sedina O'Kane https://orcid.org/0009-0007-9938-8445 2 , [...] David Mockler https://orcid.org/0000-0001-6171-8751 3 , Juliette Hussey 1,4 , Olinda Santin 5 , Emer Guinan 1,4 PUBLISHED 22 Dec 2025 Author details Author details 1 Discipline of Physiotherapy, Trinity College Dublin School of Medicine, Dublin, Leinster, Ireland 2 Queen's University Belfast School of Psychology, Belfast, Northern Ireland, UK 3 John Stearne Library, Trinity College Dublin School of Medicine, Dublin, Leinster, Ireland 4 Trinity St James Cancer Institute, St James's Hospital, Dublin, Leinster, Ireland 5 Queen's University Belfast School of Nursing and Midwifery, Belfast, Northern Ireland, UK Diana Cooke Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Project Administration, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Sedina O'Kane Roles: Investigation, Validation David Mockler Roles: Conceptualization, Investigation, Methodology, Resources Juliette Hussey Roles: Conceptualization, Funding Acquisition, Methodology, Supervision, Validation, Writing – Review & Editing Olinda Santin Roles: Conceptualization, Funding Acquisition, Methodology, Supervision, Validation, Writing – Review & Editing Emer Guinan Roles: Conceptualization, Funding Acquisition, Methodology, Supervision, Validation, Writing – Review & Editing OPEN PEER REVIEW DETAILS REVIEWER STATUS Abstract Background Barrett’s oesophagus is a premalignant condition caused by long-term gastro-oesophageal reflux disease (GORD) and carries an increased risk of oesophageal adenocarcinoma. Managing reflux symptoms such as heartburn and regurgitation is important for improving quality of life and reducing the risk of disease progression. Clinical guidelines recommend lifestyle modification alongside surveillance and medication, as factors such as diet, physical activity, smoking, alcohol use, and weight management can influence both symptom control and overall well-being. However, little is known about how people with Barrett’s oesophagus engage with these behaviours, what challenges they face in making changes, or how engagement differs across patient groups. This protocol outlines a scoping review that will map existing evidence on modifiable lifestyle behaviours in people with Barrett’s oesophagus, including their prevalence, lived experience, and variation across subgroups. Methods This scoping review will follow the Joanna Briggs Institute (JBI) methodology. A three-step search strategy will be used to identify both peer-reviewed and grey literature: (1) a limited initial search to refine keywords, (2) a comprehensive search across databases, and (3) backward and forward citation searching. Both qualitative and quantitative studies reporting on the prevalence, variation, or lived experience of lifestyle behaviours in adults with Barrett’s oesophagus will be included. Screening and data charting will be conducted using Covidence. Data will be synthesised narratively and descriptively across three domains: prevalence, variation by patient characteristics, and lived experience and reported in line with the PRISMA-ScR guidelines. Conclusion This scoping review will map the existing evidence on modifiable lifestyle behaviours in individuals with Barrett’s Oesophagus, including how these behaviours are experienced and influenced by patient characteristics. The findings will identify key evidence gaps and provide a foundation to inform future research and the development of tailored interventions to support behaviour change and improve quality of life in this population. READ ALL READ LESS Keywords Barrett’s oesophagus; Lifestyle modification; Patient characteristics; Scoping review; Symptom management Corresponding Author(s) Diana Cooke ( [email protected] ) Close Corresponding author: Diana Cooke Competing interests: No competing interests were disclosed. Grant information: This work was supported by Breakthrough Cancer Research as part of the AllCaN Oesophageal Cancer Research Programme. The funder had no role in the design of the study, the preparation of this manuscript, or the decision to submit the article for publication. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Copyright: © 2025 Cooke D et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Cooke D, O'Kane S, Mockler D et al. EXAMINING THE PREVALENCE, PATIENT PROFILES, AND EXPERIENCES OF MODIFIABLE LIFESTYLE BEHAVIOURS IN INDIVIDUALS WITH BARRETT’S OESOPHAGUS: A SCOPING REVIEW PROTOCOL [version 1; peer review: 1 approved] . HRB Open Res 2025, 8 :132 ( https://doi.org/10.12688/hrbopenres.14312.1 ) First published: 22 Dec 2025, 8 :132 ( https://doi.org/10.12688/hrbopenres.14312.1 ) Latest published: 22 Dec 2025, 8 :132 ( https://doi.org/10.12688/hrbopenres.14312.1 ) Introduction Background Barrett’s oesophagus (BO) is a premalignant condition that develops due to chronic exposure to gastro-oesophageal reflux disease (GORD), in which the normal squamous epithelium of the distal oesophagus is replaced by specialised intestinal metaplasia ( Coleman et al. , 2018 ; Souza & Spechler, 2022 ). This metaplastic change represents a key stage in the reflux–dysplasia–adenocarcinoma sequence, conferring an increased risk of progression to oesophageal adenocarcinoma (OAC), which carries one of the lowest five-year survival rates globally ( Coleman et al. , 2018 ; Mittal et al. , 2021 ; Walker & Gossage, 2023 ). OAC is typically diagnosed at an advanced stage when curative treatment options are limited and survival rates are poor, underscoring the importance of identifying and managing BO effectively to interrupt this progression pathway ( Mittal et al. , 2021 ). Although the annual risk of progression from non-dysplastic BO to OAC is relatively low, estimated at approximately 0.1–0.5% per year ( Sijben et al. , 2023 ; Thrift, 2021 ), the condition remains clinically significant due to its increasing prevalence and the poor prognosis once diagnosed ( Desai et al. , 2019 ). Notably, a systematic review indicates that only 11.8% of patients diagnosed with OAC have a documented prior diagnosis of BO, while underlying BO is detected at the time of cancer diagnosis in 56.6% of cases and in over 90% of early-stage disease ( Tan et al. , 2020 ), indicating that most BO remains undiagnosed until cancer develops. Globally, oesophageal cancer represents a major public health concern, with projections estimating nearly one million new cases and 0.9 million deaths by 2040 ( Morgan et al. , 2022 ; Sung et al. , 2021 ). The incidence of OAC continues to rise steadily in Western countries, in parallel with rising obesity rates ( Arnold et al. , 2017 ; Elliott & Reynolds, 2021 ; Sung et al. , 2021 ; Thrift, 2021 ). Obesity, particularly central adiposity, is a key modifiable risk factor for both GORD and BO ( Singh et al. , 2013 ; Xie et al. , 2024 ). These epidemiological trends highlight the pressing need for strategies that address modifiable lifestyle factors to reduce risk, improve symptom management, and enhance quality of life in this population, particularly among those already living with BO ( Kahrilas et al. , 2025 ; Mao et al. , 2022 ). Consequently, increasing attention has turned toward behavioural and lifestyle approaches that may help mitigate disease risk, alleviate symptoms, and promote overall health ( Garg, 2025 ; Mao et al. , 2022 ). In clinical practice, the management of BO focuses on preventing disease progression, alleviating reflux symptoms, and improving quality of life ( Fitzgerald et al. , 2014 ; National Institute for Health and Care Excellence, 2023 ). Reflux symptoms such as heartburn and regurgitation can be distressing ( Wickramasinghe et al. , 2023 ), significantly affecting daily functioning and quality of life ( van der Ende-van Loon et al. , 2022 ), and, if inadequately controlled, may contribute to mucosal inflammation and neoplastic change ( Argüero & Sifrim, 2024 ). Clinical guidelines recommend a multimodal approach combining pharmacological therapy, endoscopic surveillance, and lifestyle modification ( Fitzgerald et al. , 2014 ; National Institute for Health and Care Excellence, 2023 ). While medication is effective in controlling acid exposure, for many individuals, symptoms are not fully resolved by pharmacological treatment alone ( Guadagnoli et al. , 2023 ; Zou et al. , 2024 ). As a result, lifestyle modification has become a recognised key component of conservative management, providing a practical means of reducing symptom severity, improving well-being, and potentially mitigating disease progression through engagement with modifiable lifestyle behaviours ( Hungin et al. , 2022 ; Kahrilas et al. , 2025 ). Modifiable lifestyle behaviours refer to changeable daily habits, including diet, physical activity, smoking, alcohol use, sleep, medication adherence, and weight management, which have the potential to influence both symptom severity and disease-related outcomes in BO ( Asreah & Abdullhameed, 2021 ; Elfanagely et al. , 2021 ; Filiberti et al. , 2021 ; Thiruvengadam et al. , 2020 ; Wan et al. , 2024 ; Zhao et al. , 2016 ). Weight reduction has been shown to improve reflux control ( Mukhtar et al. , 2022 ), while smoking cessation and moderation of alcohol intake can reduce mucosal irritation and inflammation ( Bishehsari et al. , 2017 ; Muto et al. , 2022 ; Vaishnav et al. , 2025 ). Alongside these changes, adopting regular physical activity and dietary modification can enhance metabolic health, alleviate reflux symptoms, and improve overall well-being ( Al-Beltagi et al. , 2025 ; Herdiana, 2023 ; Severo et al. , 2025 ; Valentini et al. , 2023 ). Despite the recognised importance of lifestyle modification, engagement among individuals with BO appears inconsistent ( Realdon et al. , 2016 ; Zhang et al. , 2021 ). Patients may receive brief, limited, or infrequent lifestyle advice during routine consultations, which often lack sustained support to implement and maintain meaningful behavioural change ( Britton et al. , 2019 ; Keyworth et al. , 2021 ; Zhang et al. , 2021 ). There is also uncertainty among healthcare professionals regarding which lifestyle factors are most relevant to disease management, partly due to the limited high-quality evidence supporting non-pharmacological strategies ( Kahrilas et al. , 2024 ; Keyworth et al. , 2021 ). The existing evidence on lifestyle behaviours in BO is fragmented and heavily weighted toward epidemiological research examining behaviours as risk factors for disease onset or progression, rather than as modifiable behaviours within diagnosed populations ( Singh et al. , 2014 ; Xu et al. , 2015 ; Zhao et al. , 2016 ). While such studies have clarified the contribution of modifiable behaviours to the development of BO, they provide limited insight into how individuals manage their lifestyle after diagnosis ( Realdon et al. , 2016 ; Zhao et al. , 2021 ). Consequently, there is little understanding of how people with BO engage with modifiable behaviours as part of ongoing disease management ( Zhang et al. , 2021 ). To date, no review has comprehensively synthesised evidence on modifiable lifestyle behaviours among individuals with BO. A rapid scoping of Cochrane, PROSPERO and the Open Science Framework in April 2025 did not identify any completed or ongoing reviews with this focus. Given the conceptual breadth, heterogeneity of study designs, and early stage of the evidence base, a scoping review is the most appropriate approach to map what is known, clarify how it has been studied, and identify gaps to inform future research and patient-centred practice. Without a clear understanding of how people with BO engage with lifestyle change, clinical guidance will continue to rely on generalised rather than evidence-based, tailored recommendations. Integrating these strands of evidence is essential to capture both behavioural patterns and the social, emotional, and practical influences on engagement. This review will systematically map the breadth, range, and nature of available evidence, highlight key themes, and identify areas that warrant further investigation. The findings will contribute to the evidence base informing patient-centred strategies for supporting lifestyle modification and improving symptom management and outcomes in BO. Aim and research question The aim of this scoping review is to map and synthesise existing evidence on modifiable lifestyle behaviours among individuals with BO, focusing on their prevalence, lived experience, and variation across patient subgroups. A scoping review was chosen as the most appropriate design for this study, as it allows for a comprehensive overview of the breadth and characteristics of existing research in this area. Scoping reviews are used to map the breadth and nature of existing evidence and identify gaps in the literature. This approach was selected as appropriate to meet the aims and objectives of the current review. The objectives of this review are: To map the existing literature relating to lifestyle behaviours in individuals with Barrett’s Oesophagus, by systematically identifying and charting relevant eligible studies to provide a descriptive overview of the scope, characteristics, and focus of existing research in this area. To identify how commonly modifiable lifestyle behaviours are reported among individuals with Barrett’s oesophagus. To examine the evidence on how patient characteristics influence engagement with modifiable lifestyle behaviours, identifying subgroups within Barrett’s oesophagus who may face greater challenges in adopting or maintaining these behaviours. To explore how individuals with Barrett’s oesophagus perceive and experience lifestyle behaviours, including barriers and facilitators to behaviour change, as well as the acceptability and sustainability of lifestyle interventions. To highlight gaps in the literature that may inform future research in this area. The findings will help to identify evidence gaps and inform future research relating to lifestyle behaviours and disease management in this population. The Population–Concept–Context framework (PCC; ( Peters et al. , 2020 ), which guides the construction of clear and focused review questions and inclusion criteria, informed the development of the following review question: What is known from existing evidence about the prevalence, lived experience, and variation by patient characteristics of modifiable lifestyle behaviours among individuals with Barrett’s oesophagus? Inclusion criteria Participants Adults (≥18 years) with a confirmed diagnosis of Barrett’s oesophagus. Studies that include mixed samples (e.g., individuals with Barrett’s oesophagus and oesophageal cancer) will only be included if findings for the Barrett’s oesophagus subgroup are reported separately. Studies that focus exclusively on patients with oesophageal adenocarcinoma or other gastrointestinal conditions without distinct reporting for Barrett’s oesophagus will be excluded. Concept This scoping review will examine the prevalence, variation by patient characteristics, and lived experience of modifiable lifestyle behaviours among individuals with Barrett’s oesophagus. Modifiable lifestyle behaviours include, but are not limited to, diet, physical activity, smoking, alcohol consumption, weight management, sleep, and medication adherence, as these factors are recognised to influence reflux symptoms, disease management, and overall well-being ( Asreah & Abdullhameed, 2021 ; Elfanagely et al. , 2021 ; Filiberti et al. , 2021 ; Thiruvengadam et al. , 2020 ; Wan et al. , 2024 ; Zhao et al. , 2016 ). Studies will be included if they report any of the following: Prevalence or frequency of modifiable lifestyle behaviours within the Barrett’s oesophagus population; Variation in these behaviours across patient characteristics (e.g., age, sex, BMI, segment length, or comorbidities); or Individuals’ experiences, attitudes, perceptions, or challenges related to lifestyle behaviours or behaviour change. Studies that examine lifestyle behaviours solely as risk factors for developing Barrett’s oesophagus or progressing to oesophageal cancer will be excluded unless they also report data relevant to prevalence, variation, or lived experience within the Barrett’s oesophagus population. Context Studies conducted in either clinical or community contexts will be included. No geographical restrictions will be applied; however, only studies published in English will be included. To ensure the evidence reflects current clinical practice and lifestyle recommendations, only studies published within the last ten years (2015–2025) will be included ( Fitzgerald et al. , 2014 ). This timeframe reflects major updates to diagnostic and management guidelines for Barrett’s oesophagus, ensuring inclusion of studies aligned with contemporary practice ( Fitzgerald et al. , 2014 ). Types of sources Peer-reviewed primary research using quantitative, qualitative, or mixed-methods designs will be included, encompassing randomised controlled trials, cohort studies, cross-sectional studies, case-control studies, and qualitative studies. Reviews, meta-analyses, pooled analyses, commentaries, conference abstracts, and unpublished theses will be excluded; however, reference lists of relevant reviews will be screened to identify additional eligible primary studies. In cases where multiple studies arise from the same dataset, overlapping data will be extracted only once from the primary publication to prevent data duplication. Additional non-overlapping, unique lifestyle data will be extracted from companion publications where reported. Methods The review will be conducted in accordance with the Joanna Briggs Institute (JBI) methodology for scoping reviews and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR; ( Tricco et al. , 2018 ). Search strategy An exploratory search will be initially conducted in PubMed to identify relevant studies and develop a list of preliminary keywords and index terms. The full search strategy will then be developed in consultation with an experienced university librarian and piloted on the EMBASE database. Title and abstract screening of the pilot results will be used to refine the search terms and structure. The final search will be conducted in EMBASE (Ovid), MEDLINE (Ovid), CINAHL (EBSCOhost), and Web of Science. Reference lists of included studies and relevant reviews will be screened to identify any additional sources, and both forward and backward citation searching will be undertaken to identify any studies that may have been missed through the electronic searches. Grey literature will be searched using Google Scholar, with the first 100 results ordered by relevance screened. Study selection Search results from all databases will be collated and imported into Covidence for screening, and duplicates will be removed automatically. Titles and abstracts will then be screened independently by two reviewers (DC and SK) to assess eligibility. Studies that do not meet the inclusion criteria will be excluded at this stage. The full texts of potentially eligible studies will subsequently be retrieved and screened in duplicate by both reviewers. Any disagreements between reviewers at any stage will be resolved through discussion, and where necessary, a third reviewer (EG) will be consulted to reach a consensus. Reasons for exclusion at the full-text stage will be recorded and presented in a flow diagram. Data extraction Data will be extracted from included studies using a tool developed by the research team and informed by the Joanna Briggs Institute (JBI) guidance for scoping reviews. The tool will align with the review objectives, focusing on the prevalence, patient characteristics, and lived experience of modifiable lifestyle behaviours among individuals with Barrett’s oesophagus. The following data will be extracted: study details (author, year, country, design); aims and methods; participant characteristics (sample size, demographics, clinical factors); lifestyle behaviours addressed (e.g. diet, physical activity, smoking, alcohol, sleep, medication adherence, weight management); and key findings relating to: Prevalence of lifestyle behaviours. Variation in behaviours by patient characteristics (e.g. age, sex, socioeconomic status, disease severity). Experience of lifestyle behaviours, including but not limited to perceptions, barriers, facilitators, and engagement with lifestyle advice or interventions. Data extraction will be conducted by the lead reviewer (DC) using the data extraction tool developed by the research team and piloted to ensure clarity and consistency, any uncertainties will be discussed with a third reviewer (EG). The tool may be refined as necessary, and any modifications will be documented and reported in the final scoping review. As this review aims to map and synthesise existing evidence rather than assess study quality, a formal critical appraisal will not be conducted. Extracted data will be organised under three overarching domains: prevalence, variation, and lived experience of lifestyle behaviours. Data synthesis and presentation Results will be reported in line with the PRISMA-ScR guidelines ( Tricco et al. , 2018 ). Extracted data will be summarised in tables and accompanied by a narrative synthesis guided by the JBI framework ( Peters et al. , 2020 ). Findings will be organised thematically around three core domains: (1) prevalence of lifestyle behaviours, (2) lived experience of engaging with these behaviours, and (3) variation in engagement across patient subgroups. This approach will allow for a comprehensive understanding of how lifestyle behaviours are adopted, perceived, and maintained by individuals with Barrett’s oesophagus, highlighting barriers, facilitators, and contextual factors that influence behaviour change. It will also identify subgroups who may require additional support to initiate or sustain lifestyle changes. Quantitative data will be summarised descriptively and narratively, where applicable, and qualitative findings will be synthesised thematically. Where appropriate, results will be grouped by behaviour type, subgroup, and outcome to identify patterns or discrepancies. Meta-analysis will not be undertaken due to anticipated heterogeneity in study design and outcome measures. Ethics and consent Ethical approval and participant consent were not required as this study involves secondary analysis of data from previously published research. Data availability No new data are associated with this article. 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PubMed Abstract | Publisher Full Text Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 22 Dec 2025 ADD YOUR COMMENT Comment Author details Author details 1 Discipline of Physiotherapy, Trinity College Dublin School of Medicine, Dublin, Leinster, Ireland 2 Queen's University Belfast School of Psychology, Belfast, Northern Ireland, UK 3 John Stearne Library, Trinity College Dublin School of Medicine, Dublin, Leinster, Ireland 4 Trinity St James Cancer Institute, St James's Hospital, Dublin, Leinster, Ireland 5 Queen's University Belfast School of Nursing and Midwifery, Belfast, Northern Ireland, UK Diana Cooke Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Project Administration, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Sedina O'Kane Roles: Investigation, Validation David Mockler Roles: Conceptualization, Investigation, Methodology, Resources Juliette Hussey Roles: Conceptualization, Funding Acquisition, Methodology, Supervision, Validation, Writing – Review & Editing Olinda Santin Roles: Conceptualization, Funding Acquisition, Methodology, Supervision, Validation, Writing – Review & Editing Emer Guinan Roles: Conceptualization, Funding Acquisition, Methodology, Supervision, Validation, Writing – Review & Editing Competing interests No competing interests were disclosed. Grant information This work was supported by Breakthrough Cancer Research as part of the AllCaN Oesophageal Cancer Research Programme. The funder had no role in the design of the study, the preparation of this manuscript, or the decision to submit the article for publication. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Article Versions (1) version 1 Published: 22 Dec 2025, 8:132 https://doi.org/10.12688/hrbopenres.14312.1 Copyright © 2025 Cooke D et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics VIEWS $counts.viewCount downloads Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Cooke D, O'Kane S, Mockler D et al. EXAMINING THE PREVALENCE, PATIENT PROFILES, AND EXPERIENCES OF MODIFIABLE LIFESTYLE BEHAVIOURS IN INDIVIDUALS WITH BARRETT’S OESOPHAGUS: A SCOPING REVIEW PROTOCOL [version 1; peer review: 1 approved] . HRB Open Res 2025, 8 :132 ( https://doi.org/10.12688/hrbopenres.14312.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 1 VERSION 1 PUBLISHED 22 Dec 2025 Views 0 Cite How to cite this report: Latorre-Rodríguez AR. Reviewer Report For: EXAMINING THE PREVALENCE, PATIENT PROFILES, AND EXPERIENCES OF MODIFIABLE LIFESTYLE BEHAVIOURS IN INDIVIDUALS WITH BARRETT’S OESOPHAGUS: A SCOPING REVIEW PROTOCOL [version 1; peer review: 1 approved] . HRB Open Res 2025, 8 :132 ( https://doi.org/10.21956/hrbopenres.15754.r52829 ) The direct URL for this report is: https://hrbopenresearch.org/articles/8-132/v1#referee-response-52829 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 16 Jan 2026 Andrés R Latorre-Rodríguez , Norton Thoracic Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA Approved VIEWS 0 https://doi.org/10.21956/hrbopenres.15754.r52829 Cooke et al. presented a protocol to conduct a scoping review regarding modifiable lifestyle behaviors in patients with Barrett's esophagus. Overall, the authors propose a scoping review (ScR) following the JBI guidelines and the PRISMA-ScR checklist/guidelines for the reporting of ... Continue reading READ ALL Cooke et al. presented a protocol to conduct a scoping review regarding modifiable lifestyle behaviors in patients with Barrett's esophagus. Overall, the authors propose a scoping review (ScR) following the JBI guidelines and the PRISMA-ScR checklist/guidelines for the reporting of results. This review is novel and interesting as it incorporates not only common quantitative outcomes but also patient experiences, attitudes, etc., which are often overlooked in medical literature. This presents a great opportunity to summarize such evidence. The protocol follows a logical structure expected for this kind of evidence synthesis and presents the required methodological components to guarantee that the results of such a review are indeed related to the proposed objective and goals. I endorse the authors and support the conduction of their ScR; however, I will make some minor comments about aspects they could reconsider and/or improve. Minor comments: In the introduction, authors mentioned, "Modifiable lifestyle behaviours refer to changeable daily habits, including diet, physical activity, smoking, alcohol use, sleep, medication adherence, and weight management, which have the potential to influence both symptom severity and disease-related outcomes in BO." Further in their methods (i.e., data to be extracted), they mention "...lifestyle behaviours addressed (e.g., diet, physical activity, smoking, alcohol, sleep, medication adherence, weight management)," which is consistent. My reflection is: is medication adherence truly a lifestyle behavior? In theory, it should be considered part of the medical intervention itself, as "healthy" individuals are not susceptible to such a behavior. Authors should explain in greater detail how they plan to assess the variation in pre-specified behaviors across different patient characteristics. In my opinion, pooled data (if definitions are similar) might be analyzed in an inferential way rather than a purely descriptive way. Why do the authors limit their scope to narrative and descriptive summaries? It is understandable that authors decide to screen only studies published in the last 10 years. However, wouldn't it be more beneficial to clearly select/define the lifestyle recommendations that are going to be assessed from a single (or a couple of) current clinical guidelines and thereafter apply those criteria to studies, even if published before? I understand that there is a risk of temporal bias but it might be justified. In the search strategy, what will be the exploratory search strategy (e.g., Mesh terms, free-text terms)? Also, how will the success of the pilot results screening be defined (i.e., what will be the criteria to proceed to the formal search)? Why limit the gray literature search only to Google Scholar and why only the first 100 results? It is not clear if the study screening in the first stage will be completed in a blinded fashion. Is the rationale for, and objectives of, the study clearly described? Yes Is the study design appropriate for the research question? Yes Are sufficient details of the methods provided to allow replication by others? Yes Are the datasets clearly presented in a useable and accessible format? Not applicable Competing Interests: No competing interests were disclosed. Reviewer Expertise: Aerodigestive medicine; gastroesophageal reflux; esophageal motility; clinical research; medical biostatistics I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Latorre-Rodríguez AR. Reviewer Report For: EXAMINING THE PREVALENCE, PATIENT PROFILES, AND EXPERIENCES OF MODIFIABLE LIFESTYLE BEHAVIOURS IN INDIVIDUALS WITH BARRETT’S OESOPHAGUS: A SCOPING REVIEW PROTOCOL [version 1; peer review: 1 approved] . HRB Open Res 2025, 8 :132 ( https://doi.org/10.21956/hrbopenres.15754.r52829 ) The direct URL for this report is: https://hrbopenresearch.org/articles/8-132/v1#referee-response-52829 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 22 Dec 2025 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 Version 1 22 Dec 25 read Andrés R Latorre-Rodríguez , Norton Thoracic Institute, St. Joseph's Hospital and Medical Center, Phoenix, USA Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2026 Latorre-Rodríguez A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 16 Jan 2026 | for Version 1 Andrés R Latorre-Rodríguez , Norton Thoracic Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA 0 Views copyright © 2026 Latorre-Rodríguez A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Cooke et al. presented a protocol to conduct a scoping review regarding modifiable lifestyle behaviors in patients with Barrett's esophagus. Overall, the authors propose a scoping review (ScR) following the JBI guidelines and the PRISMA-ScR checklist/guidelines for the reporting of results. This review is novel and interesting as it incorporates not only common quantitative outcomes but also patient experiences, attitudes, etc., which are often overlooked in medical literature. This presents a great opportunity to summarize such evidence. The protocol follows a logical structure expected for this kind of evidence synthesis and presents the required methodological components to guarantee that the results of such a review are indeed related to the proposed objective and goals. I endorse the authors and support the conduction of their ScR; however, I will make some minor comments about aspects they could reconsider and/or improve. Minor comments: In the introduction, authors mentioned, "Modifiable lifestyle behaviours refer to changeable daily habits, including diet, physical activity, smoking, alcohol use, sleep, medication adherence, and weight management, which have the potential to influence both symptom severity and disease-related outcomes in BO." Further in their methods (i.e., data to be extracted), they mention "...lifestyle behaviours addressed (e.g., diet, physical activity, smoking, alcohol, sleep, medication adherence, weight management)," which is consistent. My reflection is: is medication adherence truly a lifestyle behavior? In theory, it should be considered part of the medical intervention itself, as "healthy" individuals are not susceptible to such a behavior. Authors should explain in greater detail how they plan to assess the variation in pre-specified behaviors across different patient characteristics. In my opinion, pooled data (if definitions are similar) might be analyzed in an inferential way rather than a purely descriptive way. Why do the authors limit their scope to narrative and descriptive summaries? It is understandable that authors decide to screen only studies published in the last 10 years. However, wouldn't it be more beneficial to clearly select/define the lifestyle recommendations that are going to be assessed from a single (or a couple of) current clinical guidelines and thereafter apply those criteria to studies, even if published before? I understand that there is a risk of temporal bias but it might be justified. In the search strategy, what will be the exploratory search strategy (e.g., Mesh terms, free-text terms)? Also, how will the success of the pilot results screening be defined (i.e., what will be the criteria to proceed to the formal search)? Why limit the gray literature search only to Google Scholar and why only the first 100 results? It is not clear if the study screening in the first stage will be completed in a blinded fashion. Is the rationale for, and objectives of, the study clearly described? Yes Is the study design appropriate for the research question? Yes Are sufficient details of the methods provided to allow replication by others? Yes Are the datasets clearly presented in a useable and accessible format? Not applicable Competing Interests No competing interests were disclosed. Reviewer Expertise Aerodigestive medicine; gastroesophageal reflux; esophageal motility; clinical research; medical biostatistics I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) Latorre-Rodríguez AR. Peer Review Report For: EXAMINING THE PREVALENCE, PATIENT PROFILES, AND EXPERIENCES OF MODIFIABLE LIFESTYLE BEHAVIOURS IN INDIVIDUALS WITH BARRETT’S OESOPHAGUS: A SCOPING REVIEW PROTOCOL [version 1; peer review: 1 approved] . HRB Open Res 2025, 8 :132 ( https://doi.org/10.21956/hrbopenres.15754.r52829) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://hrbopenresearch.org/articles/8-132/v1#referee-response-52829 Alongside their report, reviewers assign a status to the article: Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. 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