Clinicomanometric factors associated with clinically relevant esophagogastric junction outflow obstruction from the Sandhill high‐resolution manometry system

Song, Bong Gun; Min, Byung–Hoon; Lee, H.; Lee, J. H.; Rhee, Poong–Lyul; Kim, J. J.

doi:10.1111/nmo.13221

Cited by 38 publications

(53 citation statements)

References 25 publications

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“…In a previous study, patients with clinically relevant EGJOO had significantly higher rates of dysphagia (100% vs 24.3%, P < 0.001) and CP (85.7% vs 21.7%, P = 0.001) than those with nonclinically relevant EGJOO. 9 Of patients with EGJOO with both dysphagia and CP, 40% had clinically relevant EGJOO. The pre-dictive performance was a little disappointing.…”

Section: Discussionmentioning

confidence: 98%

“…5 Median IRP 20 mmHg was adopted as cutoff for diagnosing EGJOO in Sandhill HRM with reference to previous studies. 9,[20][21][22] As a result, a total of 169 patients with EGJOO were included in the analysis. Clinically relevant patients were defined as follows: (1) subsequent HRM met achalasia criteria during follow-up (early achalasia); (2) Eckardt score was decreased at least two points without exceeding a score of 3 after pneumatic dilatation (variant achalasia); or (3) significant passage disturbance on esophagogram without structural abnormality (possible achalasia).…”

Section: Subjectsmentioning

confidence: 99%

“…Clinically relevant patients were defined as follows: (1) subsequent HRM met achalasia criteria during follow-up (early achalasia); (2) Eckardt score was decreased at least two points without exceeding a score of 3 after pneumatic dilatation (variant achalasia); or (3) significant passage disturbance on esophagogram without structural abnormality (possible achalasia). 9 The study was performed in accordance with the ethical guidelines of the Declaration of Helsinki and approved by the institutional review board at Samsung Medical Center (IRB No. 2018-03-101).…”

Section: Subjectsmentioning

confidence: 99%

“…2,6 Recently, several studies have clearly shown that dysphagia and compartmentalized pressurization (CP) is closely related to clinically significant idiopathic EGJOO. 4,9 In real practice, prediction of the clinical relevance of EGJOO is of great importance because of its diagnostic heterogeneity.…”

Section: Introductionmentioning

confidence: 99%

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Combined Multichannel Intraluminal Impedance and High-resolution Manometry Improves Detection of Clinically Relevant Esophagogastric Junction Outflow Obstruction

Song

Lee

et al. 2019

J Neurogastroenterol Motil

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Background/AimsEsophagogastric junction outflow obstruction (EGJOO) is a diagnostically heterogeneous group with variable clinical relevance. We studied whether evaluation of bolus transit by multichannel intraluminal impedance (MII) is useful for discriminating clinically relevant EGJOO.MethodsA total 169 patients diagnosed as having EGJOO between June 2011 and February 2018 were analyzed. All the patients received a combined MII and high-resolution manometry (CMII-HRM). MII was reported as having abnormal liquid bolus transit (LBT) if < 80% of swallows had complete bolus transit. EGJOO was defined as a median integrated relaxation pressure of > 20 mmHg and when the criteria for achalasia were not met. Patients who progress to achalasia, show significant passage disturbance, or require pneumatic dilatation were defined as having a clinically relevant EGJOO.ResultsAmong the patients with EGJOO (n = 169), the clinically relevant group (n = 10) is more likely to have dysphagia (100% vs 25.2%, P < 0.001), compartmentalized pressurization (CP; 90.0% vs 22.0%, P < 0.001), and abnormal LBT (100% vs 66.7%, P = 0.032) compared to the non-relevant group (n = 159). The combination of dysphagia, CP, and abnormal LBT showed the best predictive power for clinically relevant EGJOO (sensitivity 90%, specificity 92.5%, positive predictive value 42.9%, negative predictive value 99.3%, positive likelihood ratio 11.9, and negative likelihood ratio 0.1). When CMII-HRM was used, an additional 8.3% of clinically relevant EGJOO cases were identified as compared with HRM alone.ConclusionClinically relevant EGJOO can be predicted using CMII-HRM.

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Section: Discussionmentioning

confidence: 98%

Section: Subjectsmentioning

confidence: 99%

Section: Subjectsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Combined Multichannel Intraluminal Impedance and High-resolution Manometry Improves Detection of Clinically Relevant Esophagogastric Junction Outflow Obstruction

Song

Lee

et al. 2019

J Neurogastroenterol Motil

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“…Taft´s study evaluated ESS only in achalasia patients. Nevertheless, it has been used as a generic score for symptomatic burden evaluation in different esophageal conditions, including ineffective esophageal motility (IEM), esophagogastric junction outflow obstruction (EGJOO), and different spastic/hyper‐contractile disorders …”

Section: Introductionmentioning

confidence: 99%

Fair reliability of eckardt scores in achalasia and non‐achalasia patients: Psychometric properties of the eckardt spanish version in a multicentric study

Cisternas

Monrroy

Riquelme

et al. 2020

Neurogastroenterology Motil

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Background: Eckardt symptom score (ESS) is the most used tool for the evaluation of esophageal symptoms. Recent data suggest that it might have suboptimal reliability and validity. The aims of this study were as follows: (a) Develop and validate an international Spanish ESS version. (b) Perform psychometric ESS evaluation in patients with achalasia and non-achalasia patients. Methods: Eckardt symptom score translation was performed by Delphi process. ESS psychometric evaluation was done in two different samples of patients referred for manometry. First sample: 430 dysphagia non-achalasia patients. Second sample: 161 achalasia patients. Internal consistency was evaluated using Cronbach's α and Guttman coefficient (<0.5 = unacceptable. 0.5-0.7 = fair. >0.7 = acceptable). Key Results: Our data show that in patients without and with achalasia, ESS behaves similarly. Both show a fair reliability with Cronbach's α of 0.57 and 0.65, respectively.Based on our results, we recommend interpretation of the Spanish ESS be done with caution. The psychometric quality of the ESS could not be improved by removal of any items based on the single-factor structure of the scale and no items meeting criteria for elimination. Conclusions and Inferences:Eckardt symptom score Spanish translation was developed. ESS showed a fair reliability for the evaluation of patients with any causes of dysphagia. Our results highlight the need for development and psychometric validation of new dysphagia scoring tools. K E Y W O R D Sdysphagia, Eckardt symptom score, psychometric evaluation, reliability, validity

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Integrated Relaxation Pressure and Its Diagnostic Ability May Vary According to the Conditions Used for HREM Recording

do Carmo,

de Assis Mota,

da Silva Castro Perdoná

et al. 2024

Dysphagia

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Clinicomanometric factors associated with clinically relevant esophagogastric junction outflow obstruction from the Sandhill high‐resolution manometry system

Abstract: Our results suggest that IRP of 20 mm Hg or higher could segregate clinically relevant subjects showing EGJOO in Sandhill HRM. Additionally, if subjects have both dysphagia and compartmentalized pressurization, careful follow-up is essential.

Cited by 38 publications

References 25 publications

Combined Multichannel Intraluminal Impedance and High-resolution Manometry Improves Detection of Clinically Relevant Esophagogastric Junction Outflow Obstruction

Combined Multichannel Intraluminal Impedance and High-resolution Manometry Improves Detection of Clinically Relevant Esophagogastric Junction Outflow Obstruction

Fair reliability of eckardt scores in achalasia and non‐achalasia patients: Psychometric properties of the eckardt spanish version in a multicentric study

Integrated Relaxation Pressure and Its Diagnostic Ability May Vary According to the Conditions Used for HREM Recording

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