In search of objective manometric criteria for colonic high‐amplitude propagated pressure waves

Abstract

The aims of this study were to explore all characteristics of high-amplitude propagated contractions (HAPCs) that would allow them to be distinguished from nonHAPC colonic pressure waves, and to develop computer algorithms for automated HAPC detection. Colonic manometry recordings obtained from 24 healthy volunteers were used. Automated analysis was performed to detect propagated pressure waves and to determine their amplitude, duration and area under the curve (AUC). For each of these variables distribution plots were made. Automated HAPC counts were compared to visual counts by experienced investigators. Distribution plots of 141093 colonic pressure waves lacked a bimodal pattern, as was also the case for propagated contractions (n = 8758). With increasing high-amplitude thresholds for HAPC detection, a gradual decrease in the automatically detected HAPC number was observed. These findings precluded determination of a threshold. Taking visually detected HAPCs as reference, amplitude thresholds of 100 mmHg in two channels, and 80 mmHg in one channel yielded the highest sensitivity (92%). In conclusion, objective criteria to distinguish HAPCs from other propagated pressure waves on the basis of their amplitude, duration or AUC do not exist. Automated detection of HAPCs using empirically derived criteria leads to an acceptable degree of correlation with visually detected HAPCs.

Interobserver variability in antroduodenal manometry

“…Previously, interobserver variation in GI manometry has been studied incidentally during attempts to develop computer programs for the analysis of motility data. In this context, computer programs have been evaluated against the combined responses of teams of trained observers 13–17 . Alternatively, assessment of observer characterization of motility traces has been used in attempts to generate ‘learning sets’ from which computer pattern recognition software can be devised 18 .…”

“…In this context, computer programs have been evaluated against the combined responses of teams of trained observers. [13][14][15][16][17] Alternatively, assessment of observer characterization of motility traces has been used in attempts to generate Ôlearning setsÕ from which computer pattern recognition software can be devised. 18 Interobserver variation has also been assessed in the evaluation of pull through techniques for the measurement of lower oesophageal sphincter pressure.…”

Evaluation of regional and whole gut motility using the wireless motility capsule: relevance in clinical practice

“…Colonic manometry is the conven tional method for evaluating colonic pressure and contractility, yet it has similar drawbacks to ADM, and requires a stool cleanout making it difficult to assess the colon under normal physiologic conditions [Scott, 2003;De Schryver et al 2002]. The WMC can obtain colonic pressure profiles and does not require a colonic preparation.…”

The role of tension receptors in colonic mechanosensitivity in humans

“…Contractions reaching high amplitudes and propagating caudally for >15 cm were considered high amplitude propagated contractions (HAPCs), according to published criteria. 20 Amplitude, duration, and velocity of propagation of contractions were assessed automatically using dedicated software developed in our own laboratory 21 and confirmed visually. Propagation velocity(cm/s) was calculated as the relation of distance between recording transducers with time of onset of contraction in those recording transducers.…”