PMID- 24840372
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20140520
LR  - 20220129
IS  - 2093-0879 (Print)
IS  - 2093-0887 (Electronic)
IS  - 2093-0879 (Linking)
VI  - 20
IP  - 2
DP  - 2014 Apr 30
TI  - Impedance pH Monitoring: Intra-observer and Inter-observer Agreement and 
      Usefulness of a Rapid Analysis of Symptom Reflux Association.
PG  - 205-11
LID - 10.5056/jnm.2014.20.2.205 [doi]
AB  - BACKGROUND/AIMS: Symptom reflux association analysis is especially helpful for 
      evaluation and management of proton pump inhibitor (PPI) re-fractory patients. An 
      accurate calculation requires manual editing of 24-hour multichannel intraluminal 
      impedance-pH (MII-pH) tracings after automatic analysis. Intra- and 
      inter-observer agreement as well as reliability of rapid editing confined to the 
      time around symptomatic episodes are unknown. Aim of this study was to explore 
      these topics in a prospective multicenter study. METHODS: Forty consecutive 
      patients who were off PPI therapy underwent MII-pH recordings. After automatic 
      analysis, their tracings were anonymized and randomized. Three experienced 
      observers, each one trained in a different European center, independently 
      per-formed manual editing of 24-hour tracings on 2 separate occasions. Values of 
      symptom index and symptom association proba-bility for acid and non acid reflux 
      were transformed into binary response (i.e., positive or negative). RESULTS: 
      Intra-observer agreement on symptom reflux association was 92.5% to 100.0% for 
      acid and 85.0% to 97.5% for non-acid reflux. Inter-observer agreement was 100.0% 
      for acid and 82.5% to 95.0% for non-acid reflux. Values for symptom index and 
      symptom association probability were similar. Concordance between 24-hour and 
      rapid (2 minutes-window before each symp-tomatic episode) editings for symptom 
      reflux association occured in 39 to 40 patients (acid) and in 37 to 40 
      (non-acid), de-pending on the observer. CONCLUSIONS: Intra- and inter-observer 
      agreement in classifying patients with or without symptom reflux association at 
      manual editing of 24-hour tracings was high, especially for acid reflux. 
      Classifying patients according to a rapid editing showed excellent con-cordance 
      with the 24-hour one and can be adopted in clinical practice.
FAU - Tenca, Andrea
AU  - Tenca A
AD  - Gastroenterology Unit 2, Universita degli Studi di Milano and Fondazione IRCCS 
      "Ca' Granda" - Ospedale Maggiore Policlinico, Milan, Italy.
FAU - Campagnola, Pietro
AU  - Campagnola P
AD  - Gastroenterology Unit, Universita degli Studi di Verona and Policlinico GB Rossi, 
      Verona, Italy.
FAU - Bravi, Ivana
AU  - Bravi I
AD  - Barts and The London School of Medicine and Dentistry, Queen Mary University of 
      London, London, UK.
FAU - Benini, Luigi
AU  - Benini L
AD  - Gastroenterology Unit, Universita degli Studi di Verona and Policlinico GB Rossi, 
      Verona, Italy.
FAU - Sifrim, Daniel
AU  - Sifrim D
AD  - Barts and The London School of Medicine and Dentistry, Queen Mary University of 
      London, London, UK.
FAU - Penagini, Roberto
AU  - Penagini R
AD  - Gastroenterology Unit 2, Universita degli Studi di Milano and Fondazione IRCCS 
      "Ca' Granda" - Ospedale Maggiore Policlinico, Milan, Italy.
LA  - eng
GR  - G0802313/MRC_/Medical Research Council/United Kingdom
PT  - Journal Article
PL  - Korea (South)
TA  - J Neurogastroenterol Motil
JT  - Journal of neurogastroenterology and motility
JID - 101530189
PMC - PMC4015199
OTO - NOTNLM
OT  - Esophageal pH monitoring
OT  - Inter-observer variability
OT  - Intra-observer variability
EDAT- 2014/05/21 06:00
MHDA- 2014/05/21 06:01
PMCR- 2014/04/01
CRDT- 2014/05/21 06:00
PHST- 2013/12/30 00:00 [received]
PHST- 2014/01/25 00:00 [revised]
PHST- 2014/02/21 00:00 [accepted]
PHST- 2014/05/21 06:00 [entrez]
PHST- 2014/05/21 06:00 [pubmed]
PHST- 2014/05/21 06:01 [medline]
PHST- 2014/04/01 00:00 [pmc-release]
AID - jnm.2014.20.2.205 [pii]
AID - jnm-20-205 [pii]
AID - 10.5056/jnm.2014.20.2.205 [doi]
PST - ppublish
SO  - J Neurogastroenterol Motil. 2014 Apr 30;20(2):205-11. doi: 
      10.5056/jnm.2014.20.2.205.