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Ambulatory 24‐h oesophageal impedance–pH recordings: reliability of automatic analysis for gastro‐oesophageal reflux assessment
Author(s) -
Roman S.,
Bruley Des Varannes S.,
Pouderoux P.,
Chaput U.,
Mion F.,
Galmiche J.p.,
Zerbib F.
Publication year - 2006
Publication title -
neurogastroenterology and motility
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.489
H-Index - 105
eISSN - 1365-2982
pISSN - 1350-1925
DOI - 10.1111/j.1365-2982.2006.00825.x
Subject(s) - reflux , gastro , ambulatory , gastroenterology , medicine , esophageal ph monitoring , gerd , disease
Oesophageal pH–impedance monitoring allows detection of acid and non‐acid gastro‐oesophageal reflux (GOR) events. Visual analysis of impedance recording requires expertise. Our aim was to evaluate the efficacy of an automated analysis for GOR assessment. Seventy‐three patients with suspected GORD underwent 24‐h oesophageal pH–impedance monitoring. Recordings analysis was performed visually (V) and automatically using Autoscan function (AS) of Bioview ® software. A symptom index (SI) ≥50% was considered for a significant association between symptoms and reflux events. AS analysis detected more reflux events, especially non‐acid, liquid, pure gas and proximal events. Detection of oesophageal acid exposure and acid reflux events was similar with both analyses. Agreement between V and AS analysis was good (Kendall's coefficient W > 0.750, P < 0.01) for all parameters. During pH–impedance studies, 65 patients reported symptoms. As compared to visual analysis, the sensitivity and specificity of a positive SI determined by AS were respectively 85.7% and 80% for all reflux events, 100% and 98% for acid reflux and 33% and 87.5% for non‐acid reflux. Despite good agreement with visual analysis, automatic analysis overestimates the number of non‐acid reflux events. Visual analysis remains the gold standard to detect an association between symptoms and non‐acid reflux events.