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Inter‐ and intra‐rater reproducibility of automated and integrated pressure‐flow analysis of esophageal pressure‐impedance recordings
Author(s) -
Rohof W. O.,
Myers J. C.,
Estremera F. A.,
Ferris L. S.,
Pol J.,
Boeckxstaens G. E.,
Omari T. I.
Publication year - 2014
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/nmo.12246
Subject(s) - reproducibility , intraclass correlation , dysphagia , medicine , high resolution manometry , biomedical engineering , mathematics , esophagus , surgery , statistics , achalasia
Background Automated impedance manometry pressure‐flow analysis ( AIM analysis) determines pressure measurements relative to bolus flow and has to date shown subtle variations in esophageal motility in relation to dysphagia. In this study, we assessed intra‐ and inter‐rater reproducibility of AIM metrics derived using purpose designed software. Methods Fifty patients referred for evaluation of gastro‐esophageal reflux symptoms (33 men, age 52 ± 1.9 years) underwent combined high‐resolution impedance manometry and completed a dysphagia questionnaire. From 10 liquid and 10 viscous swallows, a subset of four swallows (two saline and two viscous) was systematically selected from each patient for manual and AIM plot analysis, which was performed twice by five observers (two experts, three non‐experts). Intra‐ and inter‐rater agreement were determined using intraclass correlation coefficients. Key Results AIM plot‐based analysis showed high intra‐rater and inter‐rater reproducibility for all metrics (mean ICC s of 0.95 and 0.94, respectively). Reproducibility of metrics derived for liquid and viscous did not differ ( ICC s of 0.96 and 0.91 for liquid and viscous, respectively). In addition, metrics derived by experts had an equivalent level of reproducibility compared to non‐experts ( ICC s of 0.96 and 0.94, respectively). Variables that could be derived with commercial software (ManoView™) correlated highly with variables from AIM plot‐based analysis, such as 4‐s integrated relaxation pressure (r = 0.85) and the 20‐mmHg isobaric contour defect (r = 0.92). Conclusions & Inferences Esophageal AIM analysis is highly reproducible, independent of an observer's level of experience in esophageal motility. Therefore, AIM analysis produces data that are reliable for clinical and research purposes.