Waters KM, et al. - In Barrett esophagus (BE), the indefinite for dysplasia (IFD) category is used for biopsies that are neither unequivocally dysplastic nor negative for dysplasia (NFD). They refined the criteria in 2012 considering BE with maintained cell polarity and surface gastric-type mucin vacuoles as NFD even with mild to moderate nuclear enlargement. From 2007 to 2016, they identified a total of 1549 cases from 1130 patients with BE biopsies. The proportion of IFD cases reduced by nearly 50% from 2007 to 2016 using the improved diagnostic criteria. This change concurred with a greater proportion of IFD cases having dysplasia on the next biopsy. They noted that the refined criteria did not miss the dysplastic cases, as NFD patients had no increase in dysplasia on the next biopsy.