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This research aims to gather and analyze data about two methods used to take small tissue samples from the esophagus biopsies taken with forceps and brush biopsies. The study focuses on patients with heartburn or Barretts esophagus, a condition that can lead to cancer. The goal is to understand how these biopsy methods may help doctors predict the development of precancerous changes or cancer over five years. Participants will undergo standard clinical care involving an upper endoscopy, during which both forceps and brush biopsies of the esophagus will be taken. These biopsy results will be collected and recorded in a research database for five years to observe their impact on medical decisions and patient outcomes. The study is observational and does not involve additional treatments beyond usual care. During the study, participants biopsy results will be monitored and recorded over a five-year period. Researchers will assess how the biopsy findings influence care decisions and whether either biopsy method can predict disease progression. Participants will continue their routine medical visits and evaluations as part of this long-term observation, with all study-related data collected to support research goals.

Researchers are comparing the rates of surgical and minimally invasive interventions, as well as any harms, in Medicare beneficiaries treated with the MILD procedure versus those treated with interspinous process decompression IPD for lumbar spinal stenosis with neurogenic claudication. This observational study uses Medicare claims data to follow patients for 24 months after their initial procedure starting from January 1, 2017. The purpose is to evaluate outcomes between these two types of procedures without requiring prior patient enrollment or consent. The study includes two groups patients who received MILD, which is a percutaneous image-guided lumbar decompression performed under fluoroscopic guidance through a dorsal approach to the spine, and patients who received IPD, a different device-based decompression procedure. Data on reoperations and complications will be collected for both groups over a 24-month follow-up period using Medicare claims. Enrollment continues until the sponsor decides to stop. Participants involvement is passive as the study uses existing Medicare claims data. Researchers will monitor rates of harms related to the initial procedure and subsequent surgical or minimally invasive interventions over two years. No direct patient visits or interventions are conducted, and the study is exempt from institutional review board oversight. The total study duration extends to December 2026, covering cases treated since early 2017.