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Is the Impedance Baseline Helpful in the Evaluation of Globus Patients?

Chun YJ, Choi MG, Kim HH, Cho YK, Ku A - J Neurogastroenterol Motil (2015)

Bottom Line: The impedance baseline (IB) acquired by 24-hour multichannel intraluminal impedance monitoring has been proven to represent esophageal mucosal integrity.A total of 62 patients were analyzed.ROC curve analysis revealed that placement at a position 3 cm from the LES resulted in moderate diagnostic accuracy (area under the curve = 0.88).

View Article: PubMed Central - PubMed

Affiliation: Departments of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

ABSTRACT

Background/aims: Gastroesophageal reflux disease (GERD) has been suggested to be responsible for 23-68% of globus cases. The impedance baseline (IB) acquired by 24-hour multichannel intraluminal impedance monitoring has been proven to represent esophageal mucosal integrity. We aimed to investigate whether the IB is helpful for evaluating globus patients.

Methods: Twenty-four-hour multichannel intraluminal impedance pH tracings (MII-pH) were evaluated in globus patients. Differences in the IB between the acid reflux, non-acid reflux, and no reflux groups were analyzed. Receiver operating characteristic (ROC) curves were obtained to determine the optimal measurement point from the lower esophageal sphincter (LES).

Results: A total of 62 patients were analyzed. MII-pH showed that acid reflux, non-acid reflux, and no reflux were present in 13, 5, and 44 patients, respectively. The acid reflux group had a significantly lower IB than the other groups at a location 3 cm from the LES. ROC curve analysis revealed that placement at a position 3 cm from the LES resulted in moderate diagnostic accuracy (area under the curve = 0.88). When we set 2500 Ω as the cut-off value for acid reflux at a position 3 cm from the LES, the additional diagnostic yield for acid reflux was increased by 19.4% compared with that obtained by MII-pH.

Conclusions: IB is complementary to pH findings enabling identification of a subset of patients with co-existing acid reflux. Catheter place-ment at a location 3 cm from the LES and a cut-off value of 2500 Ω may be reasonable criteria for estimating acid reflux.

No MeSH data available.


Related in: MedlinePlus

Receiver operating characteristic curve of the impedance baseline at a position 3 cm from the lower esophageal sphincter (LES) for acid reflux assessment. The area under the curve at a position 3 cm from the LES was 0.88, indicating moderate diagnostic accuracy.
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f2-jnm-21-390: Receiver operating characteristic curve of the impedance baseline at a position 3 cm from the lower esophageal sphincter (LES) for acid reflux assessment. The area under the curve at a position 3 cm from the LES was 0.88, indicating moderate diagnostic accuracy.

Mentions: The AUCs at each point were as follows: 3 cm from the LES, 0.88 (Fig. 2); 5 cm from the LES, 0.67; 7 cm from the LES, 0.58; 9 cm from the LES, 0.62; 15 cm from the LES, 0.52 and 17 cm from the LES, 0.53. When we used a cut-off value of 2500 Ω at a position 3 cm from the LES for the diagnosis of acid reflux, the sensitivity was 0.81 (95% confidence interval [CI], 0.57–0.94), and the specificity was 0.85 (95% CI, 0.70–0.94). We defined an IB of ≤ 2500 Ω at a position 3 cm from the LES as low IB-3 and an IB of > 2500 Ω at a position 3 cm from the LES as high IB-3.


Is the Impedance Baseline Helpful in the Evaluation of Globus Patients?

Chun YJ, Choi MG, Kim HH, Cho YK, Ku A - J Neurogastroenterol Motil (2015)

Receiver operating characteristic curve of the impedance baseline at a position 3 cm from the lower esophageal sphincter (LES) for acid reflux assessment. The area under the curve at a position 3 cm from the LES was 0.88, indicating moderate diagnostic accuracy.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4496914&req=5

f2-jnm-21-390: Receiver operating characteristic curve of the impedance baseline at a position 3 cm from the lower esophageal sphincter (LES) for acid reflux assessment. The area under the curve at a position 3 cm from the LES was 0.88, indicating moderate diagnostic accuracy.
Mentions: The AUCs at each point were as follows: 3 cm from the LES, 0.88 (Fig. 2); 5 cm from the LES, 0.67; 7 cm from the LES, 0.58; 9 cm from the LES, 0.62; 15 cm from the LES, 0.52 and 17 cm from the LES, 0.53. When we used a cut-off value of 2500 Ω at a position 3 cm from the LES for the diagnosis of acid reflux, the sensitivity was 0.81 (95% confidence interval [CI], 0.57–0.94), and the specificity was 0.85 (95% CI, 0.70–0.94). We defined an IB of ≤ 2500 Ω at a position 3 cm from the LES as low IB-3 and an IB of > 2500 Ω at a position 3 cm from the LES as high IB-3.

Bottom Line: The impedance baseline (IB) acquired by 24-hour multichannel intraluminal impedance monitoring has been proven to represent esophageal mucosal integrity.A total of 62 patients were analyzed.ROC curve analysis revealed that placement at a position 3 cm from the LES resulted in moderate diagnostic accuracy (area under the curve = 0.88).

View Article: PubMed Central - PubMed

Affiliation: Departments of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

ABSTRACT

Background/aims: Gastroesophageal reflux disease (GERD) has been suggested to be responsible for 23-68% of globus cases. The impedance baseline (IB) acquired by 24-hour multichannel intraluminal impedance monitoring has been proven to represent esophageal mucosal integrity. We aimed to investigate whether the IB is helpful for evaluating globus patients.

Methods: Twenty-four-hour multichannel intraluminal impedance pH tracings (MII-pH) were evaluated in globus patients. Differences in the IB between the acid reflux, non-acid reflux, and no reflux groups were analyzed. Receiver operating characteristic (ROC) curves were obtained to determine the optimal measurement point from the lower esophageal sphincter (LES).

Results: A total of 62 patients were analyzed. MII-pH showed that acid reflux, non-acid reflux, and no reflux were present in 13, 5, and 44 patients, respectively. The acid reflux group had a significantly lower IB than the other groups at a location 3 cm from the LES. ROC curve analysis revealed that placement at a position 3 cm from the LES resulted in moderate diagnostic accuracy (area under the curve = 0.88). When we set 2500 Ω as the cut-off value for acid reflux at a position 3 cm from the LES, the additional diagnostic yield for acid reflux was increased by 19.4% compared with that obtained by MII-pH.

Conclusions: IB is complementary to pH findings enabling identification of a subset of patients with co-existing acid reflux. Catheter place-ment at a location 3 cm from the LES and a cut-off value of 2500 Ω may be reasonable criteria for estimating acid reflux.

No MeSH data available.


Related in: MedlinePlus