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Diagnosis of esophageal motility disorders: esophageal pressure topography vs. conventional line tracing
- Source :
- American journal of gastroenterology, 110(7), 967-77; quiz 978. Springer Nature
- Publication Year :
- 2015
-
Abstract
- Enhanced characterization of esophageal peristaltic and sphincter function provided by esophageal pressure topography (EPT) offers a potential diagnostic advantage over conventional line tracings (CLT). However, high-resolution manometry (HRM) and EPT require increased equipment costs over conventional systems and evidence demonstrating a significant diagnostic advantage of EPT over CLT is limited. Our aim was to investigate whether the inter-rater agreement and/or accuracy of esophageal motility diagnosis differed between EPT and CLT. Forty previously completed patient HRM studies were selected for analysis using a customized software program developed to perform blinded independent interpretation in either EPT or CLT (six pressure sensors) format. Six experienced gastroenterologists with a clinical focus in esophageal disease (attendings) and six gastroenterology trainees with minimal manometry experience (fellows) from three academic centers interpreted each of the 40 studies using both EPT and CLT formats. Rater diagnoses were assessed for inter-rater agreement and diagnostic accuracy, both for exact diagnosis and for correct identification of a major esophageal motility disorder. The total group agreement was moderate (κ=0.57; 95% CI: 0.56-0.59) for EPT and fair (κ=0.32; 0.30-0.33) for CLT. Inter-rater agreement between attendings was good (κ=0.68; 0.65-0.71) for EPT and moderate (κ=0.46; 0.43-0.50) for CLT. Inter-rater agreement between fellows was moderate (κ=0.48; 0.45-0.50) for EPT and poor to fair (κ=0.20; 0.17-0.24) for CLT. Among all raters, the odds of an incorrect exact esophageal motility diagnosis were 3.3 times higher with CLT assessment than with EPT (OR: 3.3; 95% CI: 2.4-4.5; P
- Subjects :
- Adult
Male
medicine.medical_specialty
Students, Medical
Manometry
610 Medicine & health
Gastroenterology
Article
Random Allocation
Internal medicine
medicine
Medical Staff, Hospital
Pressure
Humans
Esophageal Motility Disorders
2715 Gastroenterology
Fellowships and Scholarships
Observer Variation
Cross-Over Studies
Hepatology
business.industry
Middle Aged
medicine.disease
10219 Clinic for Gastroenterology and Hepatology
Esophageal motility disorder
Research Design
Workforce
Esophageal pressure
Female
Peristalsis
2721 Hepatology
Line (text file)
business
Software
Subjects
Details
- Language :
- English
- ISSN :
- 00029270
- Database :
- OpenAIRE
- Journal :
- American journal of gastroenterology, 110(7), 967-77; quiz 978. Springer Nature
- Accession number :
- edsair.doi.dedup.....45986b7afa2580c1e98f03e81fbe55a8